tbuckley/cabot-search huggingface dataset:
Effects of Antihypertensive Therapy on Serum Lipids
Authors: Bertram L. Kasiske, Jennie Z. Ma, Roberto S. N. Kalil, Thomas A. Louis
Journal: Annals of Internal Medicine (1995)

Purpose: To compare and contrast the effects of antihypertensive agents on serum lipids and blood pressure in different patient populations. Data Sources: A MEDLINE search and bibliographies from recent comprehensive reviews were used to identify trials that provided sufficient data to calculate the change in one or more serum lipid values measured before and after antihypertensive therapy. Study Selection: 474 controlled and uncontrolled clinical trials investigated the effects of 85 antihypertensive agents on lipids and blood pressure in more than 65 000 patients. Data Extraction: Data on triglyceride and total, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) cholesterol levels; blood pressure; patient characteristics; and study design. Data Synthesis: Differences in the effects of agents, adjusted for differences in patient populations and study design, were examined using multiple linear regression analysis that was weighted by study quality and inverse variance. Diuretics caused relative increases in cholesterol levels (regression coefficient = 0.13 mmol/L; 95% CI, 0.09 to 0.18 mmol/L) that were greater with higher doses (additional effect of high dose, 0.12 mmol/L; CI, 0.04 to 0.20 mmol/L) and were worse in blacks than in nonblacks (additional effect in blacks, 0.13 mmol/L; CI, 0.01 to 0.26 mmol/L). β-blockers caused increases in triglyceride levels (0.35 mmol/L; CI, 0.31 to 0.39 mmol/L) that were substantially smaller for agents with intrinsic sympathomimetic activity (amelioration of β-blocker increase, −0.21 mmol/L; CI, −0.27 to −0.16 mmol/L). When combined with cardioselectivity, β-blockers with intrinsic sympathomimetic activity favorably affected lipids and reduced both total (−0.14 mmol/L; CI, −0.24 to −0.04 mmol/L) and LDL cholesterol levels (−0.17 mmol/L; CI, −0.28 to −0.07 mmol/L). α-Blockers beneficially affected total cholesterol (−0.23 mmol/L; CI, −0.28 to −0.18 mmol/L), LDL cholesterol (−0.20 mmol/L; CI, −0.25 to −0.15 mmol/L), triglycerides (−0.07 mmol/L; CI, −0.11 to −0.03 mmol/L), and, in younger persons, HDL cholesterol (0.02 mmol/L; 0.01 to 0.04 mmol/L). Converting enzyme inhibitors reduced triglycerides (−0.07 mmol/L; CI, −0.12 to −0.02 mmol/L), and, in patients with diabetes, total cholesterol (−0.22 mmol/L; CI, −0.34 to −0.10 mmol/L). Vasodilators reduced total (−0.22 mmol/l; CI, −0.30 to −0.10 mmol/L) and LDL cholesterol (−0.22 mmol/L; CI, −0.29 to −0.11 mmol/L) and increased HDL cholesterol (0.06 mmol/L; CI, 0.02 to 0.09 mmol/L). Conclusion: With the exception of calcium antagonists, nearly all antihypertensive agents affect serum lipids. These effects differ among patient populations.
The management of atrial fibrillation: summary of updated NICE guidance
Authors: C. Jones, V. Pollit, D. Fitzmaurice, C. Cowan
Journal: BMJ (2014)

Atrial fibrillation is increasingly common,1 with more than 800 000 people being affected in England.2 Many people are managed in primary care without hospital involvement. The condition is a major cause of morbidity, particularly stroke, and it reduces life expectancy. Strokes caused by atrial fibrillation are largely avoidable—most can be prevented by anticoagulation. Yet uptake of anticoagulation by people with known atrial fibrillation who are at increased risk of stroke is suboptimal.3 4 5 Since the publication of the 2006 guidance, several developments relating to risk stratification, stroke prevention, and rhythm management have led to a partial update on the 2006 guidance. This article summarises the most recent recommendations from the National Institute for Health and Care Excellence (NICE).6 NICE recommendations are based on systematic reviews of best available evidence and explicit consideration of cost effectiveness. When minimal evidence is available, recommendations are based on the Guideline Development Group's experience and opinion of what constitutes good practice. Evidence levels for the recommendations are given in italic in square brackets. All recommendations below should be in accordance with the NICE patient experience guideline,7 and the benefits and risks of treatment should be discussed with the patient. ### Diagnosis and assessment
THE VIRULENCE OF DIPHTHERIA-LIKE ORGANISMS: (Further Note.)
Authors: A. J. Eagleton, E. M. Baxter
Journal: BMJ (1922)

VIRULENCE OF DIPHTHERIA-LIKE ORGANISMS,[TMTz BALT I39 than in the male.Acute degeneration of the whole -gland fonowed inoculation with the non-lipoid cortical constituents, together with adrenaline.Thyroid.-The gland was apparently stimulated by the cortex, but adrenaline over-stimulated it to the point of exhaustion.Haemrolyrnph Glands.-Themost striking change observed was in tho pigment.Three types could be distinguished.First, the yellow-brown amorphous pigment due to break- down of haemoglobin; this was always increased, showing that the suprarenal stimulates blood destruction.Secondly, bright yellow pigment in fatty droplets, probablv representing some of the inoculated lipoid material laid down in altered form in tlhese glanis.Tlhirdly, brown pigment found in special cells of.varying size and shape in varying amounts; these are melanoblast cells, and were found most frequently in the haemolymplh glands, occasionally in the truLe lymph glands, and rarely in almost any situation, distributed by the lymph channels.The suggestive point about these cells is that they were only found when the preparation contained adrenaline, and never under any other conditions.Excessive or perverted activity of the suprarenal medulla, therefore, may be directly responsible for the pigment formation of Addison's disease and may also play a part in the formation of pigmented tumours.Conclusiovs.Altlhough it is not possible to apply-results obtained witlh certain animals to another species, nor possible always to distinguish .betweenglandularlhyperactivity and perverted activity, nor between purely structural lhyperplasia and functional hyperplasia, yet the following conclusions seem wortly-of -record:1.The suprare'nal cortex plays a part in fat metabolism and in calcium metabolism.. The suprarenal cortex stimulates the thymus to
Defective blood dendritic cells in chronic myeloid leukemia correlate with high plasmatic VEGF and are not normalized by imatinib mesylate
Authors: N Boissel, P Rousselot, E Raffoux, J-M Cayuela, O Maarek, D Charron, L Degos, H Dombret, A Toubert, D Rea
Journal: Leukemia (2004)
Adherence to Surgical Care Improvement Project Measures and the Association With Postoperative Infections
Authors: Jonah J. Stulberg
Journal: JAMA (2010)

The Surgical Care Improvement Project (SCIP) aims to reduce surgical infectious complication rates through measurement and reporting of 6 infection-prevention process-of-care measures. However, an association between SCIP performance and clinical outcomes has not been demonstrated.To examine the relationship between SCIP infection-prevention process-of-care measures and postoperative infection rates.A retrospective cohort study, using Premier Inc's Perspective Database for discharges between July 1, 2006 and March 31, 2008, of 405 720 patients (69% white and 11% black; 46% Medicare patients; and 68% elective surgical cases) from 398 hospitals in the United States for whom SCIP performance was recorded and submitted for public report on the Hospital Compare Web site. Three original infection-prevention measures (S-INF-Core) and all 6 infection-prevention measures (S-INF) were aggregated into 2 separate all-or-none composite scores. Hierarchical logistical models were used to assess process-of-care relationships at the patient level while accounting for hospital characteristics.The ability of reported adherence to SCIP infection-prevention process-of-care measures (using the 2 composite scores of S-INF and S-INF-Core) to predict postoperative infections.There were 3996 documented postoperative infections. The S-INF composite process-of-care measure predicted a decrease in postoperative infection rates from 14.2 to 6.8 per 1000 discharges (adjusted odds ratio, 0.85; 95% confidence interval, 0.76-0.95). The S-INF-Core composite process-of-care measure predicted a decrease in postoperative infection rates from 11.5 to 5.3 per 1000 discharges (adjusted odds ratio, 0.86; 95% confidence interval, 0.74-1.01), which was not a statistically significantly lower probability of infection. None of the individual SCIP measures were significantly associated with a lower probability of infection.Among hospitals in the Premier Inc Perspective Database reporting SCIP performance, adherence measured through a global all-or-none composite infection-prevention score was associated with a lower probability of developing a postoperative infection. However, adherence reported on individual SCIP measures, which is the only form in which performance is publicly reported, was not associated with a significantly lower probability of infection.
Enterolactone but not genistein decreases estradiol-induced tumor growth, angiogenesis, and secreted VEGF in vivo in human breast cancer.
Authors: NM Saarinen, A Abrahamsson, C Dabrosin
Journal: Cancer Research (2009)

Abstract Abstract #5081 Phytoestrogens have been shown to be potential compounds in breast cancer prevention and treatment by poorly understood mechanisms. There are two major classes of phytoestrogens in the diet; lignans and isoflavones. One main phytoestrogen in Western diet is the mammalian lignan enterolactone (ENL) whereas soy is the major source of the isoflavone genistein (GEN) usually found in Eastern diets. In this paper we investigated the effects of ENL and GEN on estradiol induced breast cancer growth in nude mice. Ovariectomized mice treated with a continuous release of estradiol were used. MCF-7 tumors were established and mice were fed with basal diet (BD), or BD with added ENL, GEN, or a combination of ENL and GEN. Tumor growth was followed and microdialysis was used to sample extracellular VEGF and FGF-2 in vivo after 2-3 weeks of treatment. We show that ENL alone or in combination with GEN, counteracted estradiol-induced growth and angiogenesis of solid tumors. GEN alone did not affect tumor growth or angiogenesis compared with BD. The pro-angiogenic extracellular levels of VEGF in vivo were significantly decreased by ENL and ENL+GEN diets compared with tumors in the BD group whereas GEN diet alone did not affect the levels compared with BD. FGF-2 levels were similar in all groups. Our in vivo findings were confirmed in vitro. By adding ENL and/or GEN, estradiol-induced VEGF secretion in MCF-7 cells decreased significantly in the ENL and ENL+GEN groups whereas GEN alone had no effects compared with estradiol exposed cells. FGF-2 was unaffected by estrogen and phytoestrogen exposure compared with control cells without added hormones. Estradiol up-regulated VEGFR-2 in human umbilical vein endothelial cells and this up-regulation was inhibited by ENL suggesting a pro-angiogenic effect by estradiol by two different mechanisms, both of which were inhibited by the addition of ENL. Our results suggest that ENL has potent anti-estrogenic effects on ER+ breast cancer whereas GEN failed to inhibit estradiol-induced tumor growth and VEGF secretion. Various phytoestrogens may have very different effects on breast cancer. ENL may prove to be beneficial in breast cancer prevention strategies in the future while GEN may cause opposite effects. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 5081.
Relations between offending, injury and illness
Authors: J. Shepherd, D. Farrington, J. Potts
Journal: Journal of the Royal Society of Medicine (2002)

The objectives of this study were to determine relations between offending and health, and how illness and injury relate to concurrent offending--whether offending predicts health or vice versa, and whether relations persist after adjustment for childhood predictors of offending. Data collected in the Cambridge Study in Delinquent Development were analysed. This is a prospective longitudinal survey of 411 South London males first recruited at age 8. Information about injuries and illnesses between ages 16 and 18 was set against information on offending and other types of antisocial behaviour. Males who were injured (especially in assaults) tended to be convicted, to be violent, to have unskilled manual jobs and to be generally antisocial. Respiratory tract illnesses were negatively related to convictions and antisocial behaviour in general. Drug users were significantly likely to be ill. Adult convictions were predicted by childhood troublesome behaviour, daring/hyperactivity, low IQ/attainment, a convicted parent, family disruption/poor supervision and poverty. Assault injuries and respiratory tract illnesses did not predict adult convictions independently of these childhood factors. It was concluded that injury is one symptom of an antisocial personality that arises in childhood and persists into adulthood. Therefore, measures that lead to a reduction in offending should also lead to a reduction in concurrent injuries. Negative relations between a range of antisocial behaviours and respiratory tract illness deserve further study.
Interferon production by peripheral lymphocytes in HBsAg-positive liver diseases
Authors: Yasuhiro Kato, Hirohito Nakagawa, Kenichi Kobayashi, Nobu Hattori, Kiichi Hatano
Journal: Hepatology (1982)

Interferon production by lymphocytes was normal in HBsAg carriers with normal liver function tests and normal liver histology, whereas it was significantly decreased in HBsAg-positive patients with chronic active hepatitis and cirrhosis. It is possible that an impaired interferon system is causally related to the development of chronic liver disease in hepatitis B virus infection.
The Ethics of Switch/Simplify in Antiretroviral Trials: Non-Inferior or Just Inferior?
Authors: Andrew Carr, Jennifer Hoy, Anton Pozniak
Journal: PLoS Medicine (2012)

The efficacy of new antiretroviral therapy (ART) drugs is established in phase 3 trials, including in patients with virological failure (i.e., ongoing viral replication) on existing ART. In these trials, a new drug generally demonstrates improved virological control relative to placebo. Improved ART efficacy over the last 15 years has led to a dramatic decrease in the numbers of treatment-experienced patients with virological failure [1]. Because fewer patients are failing ART in resource-rich settings, enrolling such patients in superiority trials of newer drugs has become increasingly difficult.

One response to fewer patients with virological failure is to evaluate new ART drugs in patients receiving effective ART, with undetectable plasma HIV. One of us (AC) participated in one such trial that yielded adverse patient outcomes, and another (AP) independently collated these trials in the process of developing an educational resource.
High Court rules that NICE process lacked transparency
Authors: C. Dyer
Journal: BMJ (2009)

A drug company has won a High Court ruling that the processes of the National Institute for Health and Clinical Excellence (NICE) lack transparency. NICE will have to reconsider its guidelines for treatments to prevent fractures in postmenopausal women with osteoporosis.

Mr Justice Holman said that the advisory body on drug spending in the NHS in England and Wales had merely gone “through the motions so they could claim they had done their duty” in trying to get consent to disclose confidential material to the company and patient groups.

Servier Laboratories, which makes the drug strontium ranelate (Protelos), challenged guidance that it said unfairly restricted access to the treatment for NHS patients.

NICE had refused to disclose the full economic model on which its cost-benefit analysis …
Intestinal parasites and epidemiology of Australia antigen in Africa.
Authors: M Barbotin, J L Oudart
Journal: BMJ (1972)

operation and no unpleasant effects follow."This report thus appeared over a year be- fore Morton's demonstration on the use of ether, and I think it is only right to point out that nitrous oxide was in use during the period between Wells's unsuccessful demon- stration and Morton's successful one.-Iam, etc., VICTOR GOLDMAN London W.1Ketamine for Burns Surgery SIR,-The leading article "Analgesia for Burnt Patients: A Symposium" (20 May, p. 418), gives much needed publicity to a hitherto neglected facet of anaesthetic practice.The sentence on the paper and discussion on the use of ketamine as an anaesthetic agent for burns surgery is somewhat biased.It is strange to mention one of the less common and least dangerous side effects of ketamine, without making any reference to the drug's unique advantages, especially in the field of bums surgery.-Weare, etc.,
Carcinoma of the Male Breast And Klinefelter's Syndrome: Is There an Association?
Authors: D. B. Evans, R. W. Crichlow
Journal: CA A Cancer Journal for Clinicians (1987)

In 1942, Harry F. Klinefelter and col leagues described a syndrome character ized by gynecomastia, small testes, asper matogenesis, hypoleydigism, and increased excretion of follicle-stimulating hormone (FSH).'In1959, Jacobs and Strong2 re ported the sex chromosome genotype of 47,XXY in these patients, defining the ge netic basis for Klinefelter's syndrome.Subsequently, the genotype has been found in those not showing any clinical signs, a condition that might best be termed Kline feller's disease.The association of male breast cancer with Klinefelter's syndrome was first sug gested by Bauer and Erickson3 in 1955.Ten years later, Jackson et a14reported on 21 patients with carcinoma of the male breast, three with Klinefelter's syndrome.These authors postulated that the incidence of breast cancer in patients with Klinefel ter's syndrome was about the same as that for women.Hamden et a15followed with a series of 150 cases of carcinoma of the male breast, which again suggested an increased incidence in patients with Klinefelter's syndrome.These studies have since been widely quoted, and the association between
Concealed Retrograde Conduction in Complete Atrioventricular Block
Authors: STAFFORD I. COHEN, L. KENT SMITH, JULIAN M. AROESTY, PANAGIATOS VOUKYDIS, EUGENE MORKIN
Journal: Circulation (1974)

Atrio-ventricular (A-V) conduction and retrograde concealed conduction were assessed in 13 patients with complete heart block distal to the His bundle. Antegrade conduction was defined by His bundle study. The presence or absence of retrograde concealed conduction of the atrio-ventricular node was determined during ventricular pacing. Four instances of retrograde concealed conduction of the A-V node were observed.
Clinical Handbook of Psychiatry and the Law
Authors: Manuel P. Pardo
Journal: JAMA (1982)

The authors' title selection is certainly apropos for this masterful work on psychiatry and the law. It is, indeed, a handbook, full of insightful information, discussed in a format uniquely the authors'. The presentation of the material, in my view, is a tribute to their highly imaginative, clinical minds. My only regret is that, unlike most handbooks, it is not small enough to carry in your coat pocket. The book is one of the most clinically creative works to come out in the field of forensic psychiatry. It has successfully achieved what the authors stated it consistently strives to accomplish, that is, "1) always to interrelate the legal and the clinical aspects of an issue; and 2) to convey, whenever possible, something of the history of the law's approach to a problem, in the recognition that today's rule is, in most cases, merely the most recent unstable equilibrium that the
CRALBP supports the mammalian retinal visual cycle and cone vision
Authors: Yunlu Xue, Susan Q. Shen, Jonathan Jui, Alan C. Rupp, Leah C. Byrne, Samer Hattar, John G. Flannery, Joseph C. Corbo, Vladimir J. Kefalov
Journal: Journal of Clinical Investigation (2015)

Mutations in the cellular retinaldehyde-binding protein (CRALBP, encoded by RLBP1) can lead to severe cone photoreceptor-mediated vision loss in patients. It is not known how CRALBP supports cone function or how altered CRALBP leads to cone dysfunction. Here, we determined that deletion of Rlbp1 in mice impairs the retinal visual cycle. Mice lacking CRALBP exhibited M-opsin mislocalization, M-cone loss, and impaired cone-driven visual behavior and light responses. Additionally, M-cone dark adaptation was largely suppressed in CRALBP-deficient animals. While rearing CRALBP-deficient mice in the dark prevented the deterioration of cone function, it did not rescue cone dark adaptation. Adeno-associated virus-mediated restoration of CRALBP expression specifically in Müller cells, but not retinal pigment epithelial (RPE) cells, rescued the retinal visual cycle and M-cone sensitivity in knockout mice. Our results identify Müller cell CRALBP as a key component of the retinal visual cycle and demonstrate that this pathway is important for maintaining normal cone-driven vision and accelerating cone dark adaptation.
Factors protective against retinopathy in insulin-dependent diabetics free of retinopathy for 30 years
Authors: T. Dornan, J I Mann, R. Turner
Journal: BMJ (1982)

To investigate which factors might protect against the development of retinopathy 40 insulin-dependent diabetics who had remained free from retinopathy despite diabetes of long duration (mean±1 SD 30±10 years) were compared with 40 patients who had background and 47 who had proliferative retinopathy (mean durations of disease 16±5 and 19±5 years respectively). The three groups had had similar mean ages at onset of diabetes. The mean of all postprandial blood glucose measurements at hospital clinics from diagnosis of diabetes to detection of retinopathy, or to the most recent negative eye examination, was 9·9±2·1 mmol/l (178±38 mg/100 ml) in the group with no retinopathy, 11·8±2·1 mmol/l (213±38 mg/100 ml) in those with background retinopathy, and 12·4±2·1 mmol/l (223±38 mg/100 ml) in those with proliferative retinopathy (p &lt;0·0001). This difference was not reflected in present concentrations of haemoglobin A<sub>1C</sub>, probably because glycaemic control had been improved after the development of retinopathy. In the groups with background and proliferative retinopathy there were significant negative correlations between mean blood glucose concentrations and the number of years that had elapsed from diagnosis of diabetes to detection of retinopathy, suggesting that the development of both grades of retinopathy depends on the degree and duration of glycaemic exposure. The patients with no retinopathy had attended clinic more frequently (p &lt;0·025), more of them had required emergency hospital treatment for hypoglycaemia (p &lt;0·0025), and they tended to have had a lower prevalence of hyperglycaemic coma than the other groups. Although mean percentage ideal body weight and diastolic blood pressure were lower in the patients with no retinopathy at the time of study, mean body weight, blood pressure, and the prevalence of smoking in the years before the development of retinopathy had been similar in all groups, suggesting that these did not influence the development of retinopathy.
Milburn promises more hospital beds
Authors: J. Jones
Journal: BMJ (2000)

The steady fall in the number of acute hospital beds in England must be reversed if the government is to achieve its aim of expanding NHS capacity and treating more patients, Alan Milburn, the health secretary, told a Commons committee.

“We have an underdoctored, undernursed, underbedded system, and we must dramatically increase the number of patients treated and reduce waits,” Mr Milburn told MPs. “We have to see an expansion in general and acute beds.”

In evidence to the health, select committee inquiry into NHS spending, Mr Milburn strenuously defended the private finance initiative (PFI), a method for procuring new hospitals and other healthcare facilities in the NHS, against the welter of criticism that has engulfed the policy.

Some independent analyses have concluded …