tbuckley/cabot-search huggingface dataset:
Adalimumab effectively reduces the rate of anterior uveitis flares in patients with active ankylosing spondylitis: results of a prospective open-label study
Authors: M Rudwaleit, E Rødevand, P Holck, J Vanhoof, M Kron, S Kary, H Kupper
Journal: Annals of the Rheumatic Diseases (2008)

Objective: To evaluate the effect of adalimumab on the frequency of anterior uveitis (AU) flares in patients with active ankylosing spondylitis (AS). Methods: We determined the history of ophthalmologist-diagnosed AU in 1250 patients with active AS who were enrolled in a multinational, open-label, uncontrolled clinical study of treatment with adalimumab, 40 mg every other week for up to 20 weeks. All AU flares were documented throughout the adalimumab treatment period plus 70 days. We compared the rates of AU flares per 100 patient years (PYs) reported during the year before adalimumab treatment with rates during adalimumab treatment, in total and by patient subgroups. Results: The AU flare rates before adalimumab treatment were 15/100 PYs in all patients (n = 1250), 68.4/100 PYs in 274 patients with a history of AU flares, 176.9/100 PYs in 106 patients with a recent history of AU flares, 192.9/100 PYs in 28 patients with symptomatic AU at baseline and 129.1/100 PYs in 43 patients with a history of chronic uveitis. During adalimumab treatment, the rate of AU flares was reduced by 51% in all patients, by 58% in 274 patients with a history of AU, by 68% in 106 patients with a recent history of AU, by 50% in 28 patients with symptomatic AU at baseline and by 45% in 43 patients with chronic uveitis. AU flares during adalimumab treatment were predominantly mild. Two patients with periods of high AS disease activity had new-onset AU during the treatment period. Conclusions: Results of this prospective open-label study suggest that adalimumab had a substantial preventive effect on AU flares in patients with active AS, including patients with a recent history of AU flares. Clinical trials: ClinicalTrials.gov Identifier: NCT00478660.
Hepatitis Type A and Hemodialysis
Authors: WOLF SZMUNESS
Journal: Annals of Internal Medicine (1977)

Four hundred sixty patients and staff from 15 U.S. dialysis centers were surveyed by the immune adherence hemagglutination technique for antibody to hepatitis A antigen (anti-HA). The age-standardized anti-HA prevalence was 42.9% in patients and 42.1% in staff. These rates are almost identical to those of socioeconomically comparable urban volunteer blood donors never exposed to dialysis settings. There was no correlation between anti-HA prevalences and duration of dialysis treatment or employment. Among 100 patients and staff followed for 1 year 92% to 94% did not change their anti-HA status. The prevalence of anti-HA was identical in subjects with past histories of multiple blood transfusions or accidental inoculations with blood-contaminated instruments and in those without such histories. We conclude that hepatitis A virus rarely if ever spreads by parenteral mechanisms, that there is no epidemiologic evidence confirming the existence of chronic hepatitis A viremic carrier states, and that hemodialysis does not play a significant role in the spread of type A hepatitis.
Deoxyguanosine Triphosphate as a Possible Toxic Metabolite in the Immunodeficiency Associated with Purine Nucleoside Phosphorylase Deficiency
Authors: Amos Cohen, Lorraine J. Gudas, Arthur J. Ammann, Gerard E. J. Staal, David W. Martin
Journal: Journal of Clinical Investigation (1978)

Purine nucleoside phosphorylase (PNP) deficiency is associated with a severe defect in thymus-derived (T)-lymphocyte function combined with normal bone marrow-derived (B)-lymphocyte function. To investigate the role of this enzyme deficiency in the resulting immune dysfunction, we measured the levels of ribonucleoside and deoxyribonucleoside triphosphates in erythrocytes from two unrelated PNP-deficient, T-lymphocyte-deficient patients. Both PNP-deficient patients have abnormally high levels of deoxyguanosine triphosphate (deoxy-GTP) in their erythrocytes (5 and 8 nmol/ml packed erythrocytes). In contrast, normal controls and adenosine deaminase-deficient, immunodeficient patients do not have detectable amounts of deoxyGTP (<0.5 nmol/ml packed erythrocytes). We propose that deoxyguanosine, a substrate of PNP, is the potentially lymphotoxic metabolite in PNP deficiency. The mechanism of toxicity involves phosphorylation of deoxyguanosine to deoxyGTP, which acts as a potent inhibitor of mammalian ribonucleotide reductase.
Burdens and Benefits of Placebos in Antidepressant Clinical Trials: A Decision and Cost-Effectiveness Analysis
Authors: Scott Y.H. Kim, Robert G. Holloway
Journal: American Journal of Psychiatry (2003)

OBJECTIVE: The use of placebos is a necessary, if controversial, part of determining the efficacy of new antidepressants in randomized clinical trials. Such studies need to convey accurate and useful risk-benefit information to subjects since effective treatments are withheld. The authors assessed the cost-effectiveness of entering such a trial from the perspective of potential subjects. METHOD: The choice between individualized psychiatric treatment and an 8-week placebo-controlled, randomized clinical trial was modeled by using a static model. The analysis was conducted from the perspective of a potential subject who has moderate depression, is at low risk for suicide, has no comorbid conditions, and lacks adequate insurance to pay for mental health services. The trial was assumed to be free for subjects, except for indirect costs. Model outcomes included the probability of treatment response at 8 weeks and "decremental" cost-effectiveness. Data were based on reviews of published and some unpublished clinical trials of novel antidepressants that were eventually shown to be efficacious. RESULTS: A participant in a typical antidepressant efficacy trial has a chance of treatment response almost 25% less than that with individualized treatment. An uninsured participant can expect to save just over $164 for every 10% chance of response sacrificed by entering the placebo-controlled trial. CONCLUSIONS: For placebo-controlled antidepressant trials, it is possible to derive systematic and evidence-based estimates of the burdens and potential benefits to subjects. Such information may be more useful for institutional review boards and potential subjects than an unstructured enumeration of risks and benefits.
The histology of allergic rhinitis and its comparison to cellular changes in nasal lavage.
Authors: M C Lim, R M Taylor, R M Naclerio
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

To better understand how changes in cells in nasal secretions reflect changes in the nasal mucosa occurring during allergic reactions, we obtained nasal lavage and biopsy specimens from normal (n = 11) asymptomatic, seasonally allergic (n = 18), and perennially allergic (n = 18) subjects. Initial baseline lavages showed that perennially, and seasonally allergic subjects, out of their allergy seasons, had significantly higher numbers of eosinophils (p < 0.01) and neutrophils (p < 0.01) and total cell counts (p < 0.05) than normal subjects. Biopsy results showed that at baseline, seasonally allergic subjects had thicker mucosa (p < 0.01), greater numbers of intraepithelial mononuclear cells and total cells (p < 0.01), and greater numbers of subepithelial neutrophils (p < 0.001) than perennially allergic subjects. Twenty-four hours after antigen provocation, nasal lavage of allergic subjects showed an increase in the number of eosinophils (p < 0.05). Seasonally allergic subjects also had significant increases in numbers of intraepithelial mononuclear cells (p < 0.05) and total cells (p < 0.01), and in subepithelial eosinophils (p < 0.001) and mononuclear cells (p < 0.05), which were localized to the side challenged. Despite an influx in eosinophils, the epithelial layer was not changed from baseline. The data provide evidence that nasal secretions and the nasal mucosa represent two distinct cellular compartments.
Serum and synovial fluid levels of interleukin-5 in a patient with eosinophilic fasciitis.
Authors: K Nishiya, N Tanimoto, K Hashimoto, M Hashizume, A Tominaga
Journal: Annals of the Rheumatic Diseases (1996)

The National General Practice Study of Epilepsy (NGPSE) is a prospective community-based study of newly diagnosed epileptic seizures. Of 594 patients with definite epileptic seizures, 160 (26.9%) had seizures with a clinically localizable onset: 36 (22.5%) frontal, 52 (32.5%) central sensorimotor, 43 (27%) temporal, nine (5.6%) frontotemporal, and 10 each (6.3%) parietal and other posterior cortex. There was no difference among these groups in seizure frequency or remission rate; 46.5% were seizure free and 6.9% had severe epilepsy. Etiology was identifiable in 41% and focal CT and EEG abnormalities in 33% and 19%, with results discordant with the clinical seizure localization in 21% and 20%. Temporal lobe epilepsy may be underreported, as it may be more difficult to localize clinically. Extratemporal seizures are extremely common in the general population, especially frontal and central sensorimotor, in relation to cerebrovascular disease. Prognoses are similar for partial epilepsies with different clinical patterns and regions of onset and are much better than suggested in hospital-based studies. The clinical, EEG, and CT localizations may frequently be discordant in this nonrefractory group.
Assessing mental capacity: the Mental Capacity Act
Authors: Timothy R J Nicholson, William Cutter, Matthew Hotopf
Journal: BMJ (2008)

Assessing mental capacity is an important part of a clinician's role, and the recent Mental Capacity Act can help doctors when making such decisions #### Summary points Clinicians are often confronted with decisions about mental capacity. Healthcare workers in England and Wales should therefore be aware of the recent changes to how capacity is assessed and the way that adults lacking capacity are dealt with since the implementation in 2007 of the Mental Capacity Act 2005.1 The act protects people who lack the mental capacity to make decisions. Until the Mental Capacity Act 2005 was implemented no statutory law covered this area. Courts previously dealt with capacity under "common law," which consists of the accumulated judgments of individual cases. The Mental Capacity Act is underpinned by five key principles (box 1), which are illustrated in a hypothetical scenario (box 2). #### Box 1: Five key principles of the Mental Capacity Act
Great Ormond Street Hospital for Children Registry for Congenital Melanocytic Naevi: prospective study 1988-2007. Part 2-evaluation of treatments
Authors: V.A. Kinsler, J. Birley, D.J. Atherton
Journal: British Journal of Dermatology (2009)

The treatment of congenital melanocytic naevi (CMNs) has become controversial as better data on complications have been published.To determine the longer-term risks and benefits of surgery in treatment of CMNs.In this 19-year prospective study, 301 families completed yearly questionnaires about treatments and CMN changes. Forty per cent of CMNs were > 20 cm projected adult size (PAS) or multiple CMNs.Girls were more likely to have had surgical treatments. There were no significant effects of treatment on the incidence of adverse clinical outcomes, although the numbers for melanoma were small. The majority of untreated CMNs lightened spontaneously during the follow-up period. Surgical treatment and satellites at birth were independently significantly associated with reported darkening of the CMN over the follow-up period. However there was no absolute measurement of final colour. Surgical treatment was associated with decreasing hairiness of the CMN over the follow-up period. PAS was associated with increasing hairiness. Excision with tissue expanders and PAS were significantly associated with an increased incidence of new satellite lesions. A proportion of patients reported new pigmentation in previously unaffected skin at the edge of a treated area, the majority after complete excision. There was a high level of satisfaction with surgery in the < 20 cm group and in those with facial CMNs. This was significantly reduced with increasing PAS.There is no evidence here that surgery reduces the incidence of adverse clinical outcomes in childhood. The natural history of the majority of untreated CMNs is to lighten spontaneously, whereas some treatments may cause adverse effects.
Akinetic Mutism after Baclofen
Authors: Malvinder S. Parmar
Journal: Annals of Internal Medicine (1991)

Letters15 September 1991Akinetic Mutism after BaclofenMalvinder S. Parmar, MDMalvinder S. Parmar, MDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-115-6-499_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editors:Baclofen, a derivative of the inhibitory neurotransmitter gamma-aminobutyric acid, is useful for reducing frequency and severity of flexor or extensor muscle spasms (1). I report an unusual reaction in a patient with renal failure, who developed a state of "motionless, mindless wakefulness" after a single dose of baclofen. A 57-year-old woman with polycystic kidney disease and end-stage renal failure on maintenance hemodialysis was prescribed baclofen for muscle spasms unresponsive to conventional measures. After taking 10 mg of baclofen and 650 mg of acetaminophen, she fell asleep. Six hours later she was found to be unresponsive and was...Reference1. CedarbaumSchleifer JL. Drugs for Parkinson's disease, spasticity, and acute muscle spasms. In: Gilman AG, Rall TW, Niles AS, Taylor P; eds. Goodman and Gilman's—The Pharmacological Basis of Therapeutics. New York: Pergamon Press; 1990:479-80. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: University of Alberta Hospital Edmonton, Alberta T6G 2B7 Canada PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByBack off baclofen when the kidneys don't workThe case for cautious consumptionBaclofenNEUROMUSCULAR BLOCKING DRUGS AND MUSCLE RELAXANTSBaclofenNeuromuscular blocking agents and skeletal muscle relaxantsThe Universal Field Hypothesis of Catatonia and Neuroleptic Malignant SyndromeBaclofen unerotoxicity in a chronic haemodialysis patientReversible Akinetic Mutism Possibly Induced by BaclofenThe Functional Neuroanatomy of Awareness: With a Focus on the Role of Various Anatomical Systems in the Control of Intermodal AttentionBaclofen as an adjuvant analgesic 15 September 1991Volume 115, Issue 6Page: 499-500KeywordsGamma aminobutyric acidMusclesNeurotransmittersPolycystic kidney diseaseRenal failure Issue Published: 15 September 1991 PDF DownloadLoading ...
The Speed Culture: Amphetamine Use and Abuse in America
Authors: Barry I. Liskow
Journal: JAMA (1975)

Between 1972 and 1974, amphetamine, methylamphetamine, phenmetrazine and methylphenidate were classified as schedule II drugs, thus subjecting them to stringent production quotas by manufacturers, rigid record-keeping by distributors, and severe prescription limitations by physicians. The impact of this decision has markedly affected the availability of these medications and increased physician awareness of their potential for abuse. An unintended effect of this decision, however, is to cast doubt on this book's thesis that America is a "speed"-oriented society fostering use of amphetamines to perpetuate the values of achievement in men, slimness in women, and compliance to authority in children. The authors' need to maintain this thesis unfortunately detracts from much that is valuable in their book, for the amphetamines, their historical development, human pharmacology, overenthusiastic acceptance into medicine, underrated abuse potential, and often inappropriate use in "hyperactive" children, are all lucidly and objectively presented, covering a large body of literature through
Statins for all
Authors: D. Spence
Journal: BMJ (2014)

The UK National Institute for Health and Care Excellence has issued new guidelines on lipid lowering. The headlines are: lower the treatment threshold for primary prevention to people with a 10 year risk of 10%, use atorvastatin preferentially, and use the Qrisk assessment tool.1 This guidance, authored by a small group of important cholesterol specialists, is surely a scientific and thought through analysis of the research data. Shouldn’t we embrace such authoritative advice?

The guidelines rely on a simplistic model of the cause of ischaemic heart disease, assuming that its decline is merely the result of a reduction …
Chromosomal abnormalities in 478 children with acute myeloid leukemia: clinical characteristics and treatment outcome in a cooperative pediatric oncology group study-POG 8821.
Authors: S C Raimondi, M N Chang, Y Ravindranath, F G Behm, M V Gresik, C P Steuber, H J Weinstein, A J Carroll
Journal: Blood (1999)
Epidermolytic hyperkeratosis: generalized form in children from parents with systematized linear form
Authors: V. NAZZARO, E. ERMACORA, B. SANTUCCI, R. CAPUTO
Journal: British Journal of Dermatology (1990)

Journal Article Epidermolytic hyperkeratosis: generalized form in children from parents with systematized linear form Get access V. NAZZARO, V. NAZZARO I Clinica Dermatologica, University of Milan Dr V.Nazzaro, I Clinica Dermatologica, University of Milan, via Pace 9, 20122‐Milan, Italy. Search for other works by this author on: Oxford Academic Google Scholar E. ERMACORA, E. ERMACORA I Clinica Dermatologica, University of Milan Search for other works by this author on: Oxford Academic Google Scholar B. SANTUCCI, B. SANTUCCI Ospedale S. Gallicano, Rome, Italy Search for other works by this author on: Oxford Academic Google Scholar R. CAPUTO R. CAPUTO I Clinica Dermatologica, University of Milan Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 122, Issue 3, 1 March 1990, Pages 417–422, https://doi.org/10.1111/j.1365-2133.1990.tb08292.x Published: 01 March 1990
JCAHO Pain Management Standards Are Unveiled
Authors: Donald M. Phillips
Journal: JAMA (2000)

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Tamoxifen and risk of contralateral breast cancer in BRCA1 and BRCA2 mutation carriers: a case-control study
Authors: Steven A Narod, Jean-Sébastien Brunet, Parviz Ghadirian, Mark Robson, Ketil Heimdal, Susan L Neuhausen, Dominique Stoppa-Lyonnet, Caryn Lerman, Barbara Pasini, Patricia de los Rios, Barbara Weber, Henry Lynch
Journal: The Lancet (2000)
Complete Resolution of Pure Red Cell Aplasia in a Patient With Chronic Lymphocytic Leukemia Following Antithymocyte Globulin Therapy
Authors: Cynthia A. Radosevich, Leo I. Gordon, Susan C. Weil, Robert J. Marder, Steven T. Rosen
Journal: JAMA (1988)

Pure red cell aplasia has been reported to be associated with chronic lymphocytic leukemia. It has been proposed that this complication may be a result of T-cell populations that suppress erythropoiesis. It has been postulated that antithymocyte globulin might reverse this abnormality by eliminating the population of suppressor T cells responsible for this inhibition. We treated a 74-year-old man who had B-cell chronic lymphocytic leukemia and pure red cell aplasia that was refractory to cytotoxic and corticosteroid therapy with equine antithymocyte globulin and methylprednisolone sodium succinate. This therapy resulted in a durable complete remission of both the chronic lymphocytic leukemia and the pure red cell aplasia and was associated with normalization of helper/suppressor T-cell ratios in the bone marrow. Antithymocyte globulin should be investigated further as a therapeutic modality for patients with pure red cell aplasia associated with chronic lymphocytic leukemia. (<i>JAMA</i>1988;259:723-725)
Self-induced Fatal Air Embolism in a Man
Authors: R. T. Cooke
Journal: BMJ (1961)

upper third of the legs, and the lower part of the abdomen.Around the calcium deposit over the right elbow there was inflammation with a discharging ulcerated area.Investigations now gave the following results: Urine: albumin + +, scanty erythrocytes, numerous casts.Hb, 16.1 g./100 ml.; W.B.C., 6,000 (normal differential); E.S.R. 57 mm./ 1st hour (Westergren); L.E. cells absent; R.A.
Abstract 1722: c-Met overexpression contributes to the acquired apoptotic resistance of non-adherent ovarian cancer cells through a cross-talk mediated by phosphatidylinositol 3-kinase and extracellular signal-regulated kinase 1/2
Authors: Maggie K. S. Tang, Hong Y. Zhou, Judy W. P. Yam, Alice S. T. Wong
Journal: Cancer Research (2010)

Abstract Ovarian cancer is the most lethal gynecological cancer mainly due to widespread peritoneal dissemination and malignant ascites. Key to this is the capacity of tumor cells to escape suspension-induced apoptosis (anoikis), which also underlies their resistance to chemotherapy. Here we utilized a non-adherent cell culture model to investigate molecular mechanisms of apoptotic resistance of ovarian cancer cells that may mimic the chemoresistance found in solid tumors. We found that ovarian cancer cells acquired a remarkable resistance to anoikis and apoptosis induced by exposure to clinically relevant doses of two front-line chemotherapeutic drugs cisplatin and paclitaxel when grown in three-dimensional (3D) than monolayer cultures. Inhibition of the hepatocyte growth factor (HGF) receptor c-Met, which is frequently overexpressed in ovarian cancer, by a specific inhibitor or small interfering RNA blocked the acquired anoikis resistance and restored chemosensitivity in 3D, not in 2D cultures. These effects were found to be dependent on both phosphatidylinositol 3-kinase (PI3K)/Akt and extracellular-signal regulated kinase (ERK) 1/2 signaling pathways. Inhibitors of PI3K/Akt abrogated ERK1/2 activation and its associated anoikis resistance in response to HGF, suggesting a signaling relay between these two pathways. Furthermore, we identified, as a mechanism of this cross-talk, a central role of Ras. Interestingly, Ras did not lie upstream of PI3K/Akt, whereas PI3K/Akt signaling to ERK1/2 involved Ras. These findings shed new light on the apoptotic resistance mechanism of non-adherent ovarian cancer ascites cells (This study was supported by Hong Kong Research Grants Council 7599/05M and Committee on Research and Conference Grant HKU200807176203 to A.S.T.W.). Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 1722.