tbuckley/cabot-search huggingface dataset:
Efficacy of infliximab on MRI-determined bone oedema in psoriatic arthritis
Authors: H. Marzo-Ortega, D. McGonagle, L. A Rhodes, A. Lyn Tan, P. G Conaghan, P. O'Connor, S. F Tanner, A. Fraser, D. Veale, P. Emery
Journal: Annals of the Rheumatic Diseases (2006)

Psoriatic arthritis (PsA) is commonly associated with bone pathology, including entheseal new bone formation and osteolysis. On MRI, areas of active clinical involvement are represented by bone oedema and synovitis.To assess the impact of infliximab on bone oedema in PsA as shown by MRI.18 patients with joint swelling, psoriasis and seronegativity for rheumatoid factor received four infusions of infliximab, 3 mg/kg, in combination with methotrexate. MRI of the affected hand (12 patients) or knee joints (6 patients) was performed before and after treatment. The primary outcome was the assessment of bone oedema and synovitis at 20 weeks as shown by MRI. Secondary outcomes included the American College of Rheumatology (ACR) response criteria, psoriasis skin scores (Psoriasis Area and Severity Index (PASI)) and a quality of life measure (Psoriatic Arthritis Quality of Life (PsAQoL)).At baseline, bone oedema was seen in 50% of patients (seven hands and two knees) in 30% of scanned joints, and this improved or resolved in all cases in the hand joints (p = 0.018) and in one knee joint at 20 weeks. Synovitis was found to be reduced in 90% of cases on MRI. Likewise, a significant improvement in all clinical outcomes, including PASI (p = 0.003) and PsAQoL (p = 0.006) was seen at week 20. 65% (n = 11) of the patients achieved an ACR response, of whom 45% had ACR70 or above and 54% had ACR20 or ACR50.Infliximab treatment is associated with dramatic improvements in MRI-determined bone oedema in PsA in the short term. It remains to be determined whether infliiximib treatment is the cause for prevention of new bone formation, bone fusion or osteolysis in PsA as shown by radiography.
Phase 1/2 and extension study of velaglucerase alfa replacement therapy in adults with type 1 Gaucher disease: 48-month experience
Authors: Ari Zimran, Gheona Altarescu, Mici Philips, Drorit Attias, Marina Jmoudiak, Maher Deeb, Nan Wang, Kiran Bhirangi, Gabriel M. Cohn, Deborah Elstein
Journal: Blood (2010)
Gastric Intramural pH as a Predictor of Success or Failure in Weaning Patients from Mechanical Ventilation
Authors: Z. Mohsenifar
Journal: Annals of Internal Medicine (1993)

Objective: To determine whether gastric intramural pH (pHi), an indirect measure of gastric mucosal ischemia, can be used to predict the success of weaning from mechanical ventilation. Gastric mucosal ischemia (and, therefore, acidosis) may develop in patients during unsuccessful attempts to wean them from mechanical ventilation because blood flow from nonvital areas (for example, splanchnic bed) is diverted to meet the increased demands of respiratory muscles. Design: Cohort study. Setting: Intensive care unit. Patients: Twenty-nine patients receiving assisted mechanical ventilation for respiratory failure who were thought by their physicians to be weanable from mechanical ventilation. Measurements: Simultaneous samples of arterial blood and gastric juice were obtained from patients during assisted mechanical ventilation, as well as during weaning trials. The predictor variable, pHi, was calculated using the following equation: 6.1 + log HCO3/(gastric Pco 2 0.0307). The outcome was success or failure of weaning, decided by physicians blinded to the study. Results: Patients who could not be weaned from mechanical ventilation had a substantially reduced gastric pHi (7.36 during mechanical ventilation compared with 7.09 during weaning [difference, 0.27; 95% CI, 0.12 to 0.42; P < 0.01]). Patients who were successfully weaned from mechanical ventilation showed no change in pHi (7.45 during mechanical ventilation compared with 7.46 during weaning [difference, 0.01; CI, 0.01 to 0.03; P = 0.29]). The sensitivity and specificity of pHi in predicting weaning success or failure were both 100% (CI, 81 to 100 and 72 to 100, respectively). Conclusion: Gastrointestinal acidosis may be an early sign of weaning failure. Measurement of pHi, which is simple and rapid, may be of practical value in predicting the likelihood of weaning success or failure during weaning trials.
Non–Q-Wave Versus Q-Wave Myocardial Infarction After Thrombolytic Therapy
Authors: Shaun G. Goodman, Anatoly Langer, Allan M. Ross, Nancy M. Wildermann, Alejandro Barbagelata, Elena B. Sgarbossa, Galen S. Wagner, Christopher B. Granger, Robert M. Califf, Eric J. Topol, Maarten L. Simoons, Paul W. Armstrong
Journal: Circulation (1998)

Although the stratification of patients with myocardial infarction into ECG subsets based on the presence or absence of new Q waves has important clinical and prognostic utility, systematic evaluation of the impact of thrombolytic therapy on the subsequent development and prognosis of non-Q-wave infarction has been limited to date.We examined 12-lead ECG, coronary anatomy, left ventricular function, and mortality among 2046 patients with ST-segment elevation infarction from the Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries angiographic subset to gain further insight into the pathophysiology and prognosis of Q- versus non-Q-wave infarction in the thrombolytic era. Non-Q-wave infarction developed in 409 patients (20%) after thrombolytic therapy. Compared with Q-wave patients, non-Q-wave patients were more likely to present with lesser ST-segment elevation in a nonanterior location. The infarct-related artery in non-Q-wave patients was more likely to be nonanterior (67% versus 58%, P=.012) and distally located (33% versus 39%, P=.021). Early (90-minute, 77% versus 65%, P=.001) and complete (54% versus 44%, P<.001) infarct-related artery patency was greater among the non-Q-wave group. Non-Q-wave patients had better global (ejection fraction, 66% versus 57%; P<.0001) and regional left ventricular function (10 versus 24 abnormal chords, P=.0001). In-hospital, 30-day, 1-year, and 2-year (6.3% versus 10.1%, P=.02) mortality rates were lower among non-Q-wave patients.The excellent prognosis among the subgroup of patients who develop non-Q-wave infarction after thrombolysis is related to early, complete, and sustained infarct-related artery patency with resultant limitation of left ventricular infarction and dysfunction.
Niemann-Pick C1 protects against atherosclerosis in mice via regulation of macrophage intracellular cholesterol trafficking
Authors: Jessie R. Zhang, Trey Coleman, S. Joshua Langmade, David E. Scherrer, Lindsay Lane, M. Hunter Lanier, Chu Feng, Mark S. Sands, Jean E. Schaffer, Clay F. Semenkovich, Daniel S. Ory
Journal: Journal of Clinical Investigation (2008)

Niemann-Pick C1 (NPC1) is a key participant in cellular cholesterol trafficking. Loss of NPC1 function leads to defective suppression of SREBP-dependent gene expression and failure to appropriately activate liver X receptor-mediated (LXR-mediated) pathways, ultimately resulting in intracellular cholesterol accumulation. To determine whether NPC1 contributes to regulation of macrophage sterol homeostasis in vivo, we examined the effect of NPC1 deletion in BM-derived cells on atherosclerotic lesion development in the Ldlr-/- mouse model of atherosclerosis. High-fat diet-fed chimeric Npc1-/- mice reconstituted with Ldlr-/-Npc1-/- macrophages exhibited accelerated atherosclerosis despite lower serum cholesterol compared with mice reconstituted with wild-type macrophages. The discordance between the low serum lipoprotein levels and the presence of aortic atherosclerosis suggested that intrinsic alterations in macrophage sterol metabolism in the chimeric Npc1-/- mice played a greater role in atherosclerotic lesion formation than did serum lipoprotein levels. Macrophages from chimeric Npc1-/- mice showed decreased synthesis of 27-hydroxycholesterol (27-HC), an endogenous LXR ligand; decreased expression of LXR-regulated cholesterol transporters; and impaired cholesterol efflux. Lower 27-HC levels were associated with elevated cholesterol oxidation products in macrophages and plasma of chimeric Npc1-/- mice and with increased oxidative stress. Our results demonstrate that NPC1 serves an atheroprotective role in mice through regulation of LXR-dependent cholesterol efflux and mitigation of cholesterol-induced oxidative stress in macrophages.
Whatever Happened to the "Old-Time" Infections
Authors: Edward B. Shaw
Journal: JAMA (1975)

To the Editor.—  This comment is on Whatever Happened to the 'Old-Time' Infections by Louis Weinstein (229:196, 1974). I have great admiration for Dr. Weinstein and always read his articles with great interest.  He comments on the fact that there may be periodic changes in epidemicity, but does not use this as an explanation for several of the things he has mentioned. There was a nationwide epidemic of diphtheria in about 1875; thereafter, until the extremely potent vaccine was developed, there was periodic increase in incidence about every five years. This periodicity of incidence also applied to measles, which had about a three-year cycle. This may account for the increase he described in Massachusetts, rather than the explanation that children born in the last two years had not been immunized—measles is a disease of early school age and those under 2 years of age are usually only infected from siblings
Managing Suicidal Behavior
Authors: Harvey L. Ruben
Journal: JAMA (1979)

SUICIDE is the most extreme behavior physicians confront. When a patient commits suicide, it may be a result of our failure to intervene effectively. It may make us angry, for the act itself is an extremely hostile communication, but it also invokes a sense of guilt at our inability to prevent an unnecessary death. Modern suicidologists classify suicide as either interpersonal or intrapersonal. Interpersonal suicide victims make frequent threats and attempts to kill themselves. They possess emotional lability, ill-defined suicide plans, and a fairly clear idea of how their crisis might be resolved. Intrapersonal suicide victims are less open in showing their suicidal drives and are withdrawn rather than emotional. They show clearly formulated plans but have no solutions other than suicide to end their crisis. Both types may result from the loss of a valued person, an intangible, or their self-esteem. The intrapersonal victim is less accessible and more
Ethinyl Estradiol and Norethindrone in the Treatment of Primary Hyperparathyroidism in Postmenopausal Women
Authors: Peter L. Selby, Munro Peacock
Journal: New England Journal of Medicine (1986)

Treatment with ethinyl estradiol or norethindrone reduces the bone-turnover rate and plasma calcium levels in normal postmenopausal women, without affecting the secretion of calcium-regulating hormones. To assess the effect of these sex steroids in patients with primary hyperparathyroidism, we treated postmenopausal women who had hyperparathyroidism with either ethinyl estradiol (n = 6) or norethindrone (n = 11). After three weeks of treatment, the bone-turnover rate declined and plasma calcium fell from a mean (±1 SE) of 2.77±0.07 mmol per liter (11.1±0.3 mg per deciliter) to 2.58+0.05 mmol per liter (10.3±0.2 mg per deciliter; P<0.01) in the group treated with ethinyl estradiol, and from 2.93±0.08 mmol per liter (11.7±0.3 mg per deciliter) to 2.84±0.08 mmol per liter (11.4±0.3 per deciliter; P<0.05) in the patients who received norethindrone. No significant changes in the plasma levels of parathyroid hormone, calcitonin, or calcitriol were observed after the estrogen-induced increases in vitamin D–binding protein had been taken into account. Since the decline in plasma calcium levels did not stimulate secretion of parathyroid hormone, we conclude that treatment with either sex steroid resets the threshold for secretion of parathyroid hormone. Thus, although the reductions in plasma calcium levels were moderate, sex-hormone therapy may be useful in the treatment of mild hyperparathyroidism in postmenopausal women. (N Engl J Med 1986;314:1481–5.)
Contamination of Fiberoptic Upper Intestinal Endoscope
Authors: L. R. Kaplan
Journal: JAMA (1979)

ABSTRACT To the Editor.— The article by Beecham et al (241:1013, 1979), Salmonella typhimurium: Transmission by Fiberoptic Upper Gastrointestinal Endoscopy, is an important reminder to endoscopists that their instruments may infect patients. However, when discussing possible sources of infection, the authors failed to mention culturing the endoscopy wash bottle, a reservoir common to all procedures. The antifoaming simethicone solution routinely placed into the wash bottle may also be source of contamination. The wash bottle should be regularly disinfected, and the simethicone solution should be discarded after its expiration date.
Long-Term Patency Rate of Right Internal Thoracic Artery Bypass Via the Transverse Sinus
Authors: Masashi Ura, Ryuzo Sakata, Yoshihiro Nakayama, Yoshio Arai, Taro Saito
Journal: Circulation (1998)

Background —Although concern regarding patency and possible compromise of graft blood flow by routing the right internal thoracic artery (RITA) through the transverse sinus has been raised, little is known about long-term patency. Methods and Results —To evaluate long-term patency of in situ RITA bypass via the transverse sinus, our first 115 patients (94 men, 21 women; mean age, 62.5 years; range, 13 to 77 years) who were alive in 1998 were enrolled for angiographic study. Only good-caliber grafts with no occlusion, string sign, or significant stenosis were considered patent. Early postoperative angiography had been performed 2 to 3 weeks after surgery in 114 patients. The early patency rates were 97.1% for RITA and 95.4% for left internal thoracic artery (LITA) grafts. Of 109 long-term survivors, 73 (67.0%) consented to have late angiographic restudy at a mean of 59 months (range, 9 to 93 months); 89.9% of RITA and 92.3% of LITA grafts were patent. Cumulative patency rates (actuarial curves) at 6 years were 89.3% (95% CI, 85% to 94%) for RITA and 94.5% (95% CI, 92% to 97%) for LITA, the differences not reaching statistical significance (multivariate Cox analysis). Conclusions —Our study demonstrated good long-term patency of in situ RITA bypass grafting via the transverse sinus for revascularization of the circumflex and diagonal arteries and supports its continued use.
Effects of Guanethidine and Methyldopa on a Standardized Test for Renin Responsiveness
Authors: STEPHEN C. LOWDER
Journal: Annals of Internal Medicine (1975)

A standardized test for renin responsiveness, employing the dual stimulus of upright posture and the loop diuretic furosemide, was applied to 19 hypertensive patients in the untreated state and during therapy with the antihypertensive agents guanethidine and methyldopa. During therapy with guanethidine, 6 of 10 patients with "low-renin essential hypertension" experienced elevations of plasma renin activity to levles ordinarily diagnostic of "normal-renin" hypertension (P less than 0.05), whereas methyldopa had no significant effect on plasma renin activity in either "low-renin" or "normal-renin" patients. It is suggested that methyldopa has a negligible influence on renin responsiveness when stimulated under the above conditions and that it may be used during assessment of plasma renin activity in hypertensive patients whose blood pressure is too severely elevated for temporary withdrawal of therapy.
Current Trends in Biologic Products
Authors: Elliott S. Robinson
Journal: New England Journal of Medicine (1945)

THE following remarks on current trends in biologic products, not being based on a careful survey of current literature or opinion, represent only an expression of the impressions gained through some years of intimate contact with the manufacture of biologic products. Had there been more opportunity for painstaking study and preparation, the comments to be made might have undergone some alteration and doubtless would have greater value; but in these days, time for leisurely consideration has for many people joined those things that have essentially ceased to exist.Current trends are discernible only against the background of what has happened . . .
Understanding sex differences in environmental health: a thought leaders' roundtable.
Authors: Sarah K Keitt, Thomas F Fagan, Sherry A Marts
Journal: Environmental Health Perspectives (2003)

Under the auspices of the Society for Women's Health Research, a thought leaders' roundtable was convened at the National Institute of Environmental Health Sciences in October 2002 to discuss recent advances in environmental health research, particularly those findings that explain sex differences in response to environmental exposures. Researchers discussed the latest findings on the interaction between sex and environmental exposures on health. Participants concluded that a greater focus on interdisciplinary, hypothesis-driven research is essential to advancing the field. To understand fully the potential effect of chronic exposures, researchers need to develop models to explore not only physiologic sex differences but also behavioral responses to low-dose and multiple chemical exposures. Future research should examine sex differences from the cell line to behaviors and should track these differences across multiple generations. Federal agencies should support such research in their awards of investigator-initiated grants.
Isoniazid Induction of Antinuclear Antibodies
Authors: NAOMI F. ROTHFIELD
Journal: Annals of Internal Medicine (1978)

We prospectively studied 102 patients admitted to the Chest Service with tuberculosis. Four patients (4%) had antinuclear antibodies before therapy and 22 patients (21.6%) developed antinuclear antibodies after treatment. None developed lupus erythematosus cells or signs or symptoms of systemic lupus erythematosus. Age and race were not related to the induction of antinuclear antibodies. The percent of positive sera was similar during and after 3 months of treatment, with higher titers after 3 months of therapy. Although patients were treated with various antituberculosis drugs, isoniazid alone or in combination with other drugs induced antinuclear antibodies.
CLA-1/SR-BI Is Expressed in Atherosclerotic Lesion Macrophages and Regulated by Activators of Peroxisome Proliferator-Activated Receptors
Authors: Giulia Chinetti, Franck G. Gbaguidi, Sabine Griglio, Ziad Mallat, Micheline Antonucci, Philippe Poulain, John Chapman, Jean-Charles Fruchart, Alain Tedgui, Jamila Najib-Fruchart, Bart Staels
Journal: Circulation (2000)

Background —The scavenger receptors are cell-surface receptors for native and modified lipoproteins that play a critical role in the accumulation of lipids by macrophages. CLA-1/SR-BI binds HDL with high affinity and is involved in the cholesterol reverse-transport pathway. Peroxisome proliferator–activated receptors (PPARs) are transcription factors regulating the expression of genes implicated in lipid metabolism, cellular differentiation, and inflammation. Here, we investigated the expression of CLA-1/SR-BI in macrophages and its regulation by PPARs. Methods and Results —CLA-1 is undetectable in human monocytes and is induced upon differentiation into macrophages. Immunohistological analysis on human atherosclerotic lesions showed high expression of CLA-1 in macrophages of the lipid core colocalizing with PPARα and PPARγ staining. Activation of PPARα and PPARγ resulted in the induction of CLA-1 protein expression in monocytes and in differentiated macrophages. Finally, SR-BI expression is increased in atherosclerotic lesions of apoE-null mice treated with either PPARγ or PPARα ligands. Conclusions —Our data demonstrate that CLA-1/SR-BI is expressed in atherosclerotic lesion macrophages and induced by PPAR activation, identifying a potential role for PPARs in cholesterol homeostasis in atherosclerotic lesion macrophages.
Accuracy of real-time vs. blinded offline diagnosis of neoplastic colorectal polyps using probe-based confocal laser endomicroscopy: a pilot study
Authors: M. Shahid, A. Buchner, M. Raimondo, T. Woodward, M. Krishna, M. Wallace
Journal: Endoscopy (2012)

Probe-based confocal laser endomicroscopy (pCLE) is a new imaging modality that enables histological examination of gastrointestinal mucosa during endoscopic procedures. Most studies have evaluated offline interpretation of pCLE images. In clinical practice, real-time interpretation is necessary to assist decision-making during the procedure. The aim of this pilot study was to compare the accuracy of real-time pCLE diagnosis made during the procedure with that of blinded offline interpretation to provide accuracy estimates that will aid the planning of future studies.pCLE was performed in patients undergoing screening and surveillance colonoscopy. Once a polyp had been identified, one endoscopist analyzed pCLE images during the procedure and made a provisional "real-time" diagnosis. Saved video recordings were de-identified, randomized, and reviewed "offline" 1 month later by the same endoscopist, who was blinded to the original diagnoses.Images from a total of 154 polyps were recorded (80 neoplastic, 74 non-neoplastic). The overall accuracy of real-time pCLE diagnosis (accuracy 79%, sensitivity 81%, specificity 76%) and offline pCLE diagnosis (83%, 88%, and 77%, respectively) for all 154 polyps were similar. Among polyps < 10 mm in size, the accuracy of real-time interpretation was significantly lower (accuracy 78%, sensitivity 71%, specificity 83%) than that of offline pCLE interpretation (81%, 86%, 78%, respectively). For polyps ≥ 10 mm, the accuracy of pCLE diagnosis in real-time was better (accuracy 85%, sensitivity 90%, specificity 75%) than offline pCLE diagnosis (81%, 97%, and 50%, respectively).These results suggest that real-time and offline interpretations of pCLE images are moderately accurate. Real-time interpretation is slightly less accurate than offline diagnosis, but overall both are comparable. Additionally, there was contrasting accuracy between the two methods for small and large polyps.
Adriamycin
Authors: RONALD H. BLUM
Journal: Annals of Internal Medicine (1974)

Adriamycin, a new antineoplastic drug, induces objective tumor responses in solid tumors (adenocarcinoma of the breast, malignant sarcomas, bronchogenic carcinoma, and neuroblastoma) as well as in hematologic malignancies (malignant lymphomas and acute leukemia). The responses in specific tumor types are reviewed, and the relative clinical efficacy of adriamycin is compared with that of other antitumor agents. The toxic effects of adriamycin are also reviewed. Adriamycin therapy results in dose-limiting hematologic and cardiac toxicity, as well as stomatitis, nausea, vomiting, and alopecia, but in general these toxicities are predictable and reversible. The theoretical limitations of this type of review are pointed out.