tbuckley/cabot-search huggingface dataset:
Infliximab rescue therapy for steroid refractory acute severe ulcerative colitis in the exeter ibd cohort
Authors: O. Waters, M. Saunders, M. Clarke, T. Daneshmend, T. Ahmad
Journal: Gut (2011)

<h3>Introduction</h3> Infliximab (IFX) has been shown to be efficacious in the treatment of steroid refractory acute severe ulcerative colitis (ASUC) with reduced rates of colectomy at index admission and at 3-year follow-up. Previous studies from tertiary referral centres have reported short-term outcomes and adverse events reported in the hospital setting only. <h3>Methods</h3> To review the short and long-term efficacy and adverse events of IFX rescue therapy in patients with ASUC in a secondary care setting. The authors rigorously reviewed hospital notes and primary care records of all patients treated with IFX as rescue therapy for steroid refractory ASUC in Exeter. The primary end point was colectomy-free survival. Secondary outcomes included physician and patient assessment of response and adverse events. <h3>Results</h3> 32 patients received IFX for ASUC between December 2005 and November 2010, with a median follow-up postinfusion of 15 months (range 0–53 IQR 33). On admission 30/32 patients met the Truelove and Witts criteria for ASUC. 2 patients had co-existing <i>Clostridium difficile</i> infection. Mean CRP at admission and prior to IFX was 48 and 28 mg/l respectively. The median time from admission to first dose of infliximab was 7 days (range 1–31 IQR 7). 32% of patients received IFX within 1 month of diagnosis. One patient who came to colectomy was found to have ischaemic colitis with superimposed fulminant CMV colitis, rather than UC. Of the remaining 31 patients, 20/31 (65%) received a 3 dose induction regimen. After the index admission 19% had maintenance therapy and 15% had episodic dosing. 5 (16%) had a colectomy at index admission. Global physician assessment and patient assessment deemed 8/31 (26%) and 7/31 (23%) as primary non-responders to IFX respectively. At 12, 24 and 48 months follow-up 11 (48%), 13 (55%) and 14 (64%) had undergone colectomy. Logistic regression analysis failed to identify any clinical or laboratory parameter that predicted outcome in this IFX treated group. Adverse events on index admission included one fulminate CMV colitis, one post-op wound infection and 2 mild infusion reactions. Adverse events on follow-up included 1 episode of <i>C difficile</i> infection and 1 <i>Campylobacter</i> infection resulting in colectomy. <h3>Conclusion</h3> This is the largest reported UK cohort of patients treated with IFX for ASUC, with the longest median follow-up. Response rates are comparable with previous studies, with 16% undergoing colectomy at index admission and 64% at 48 months. Comprehensive review of both primary and secondary care notes demonstrated an acceptable rate of adverse events with 13% developing serious infections, 2 at index admission and 2 while receiving IFX maintenance therapy.
Rapamycin Induces Heme Oxygenase-1 in Human Pulmonary Vascular Cells
Authors: Gary A. Visner, Fuhua Lu, Hailan Zhou, Jun Liu, Kristy Kazemfar, Anupam Agarwal
Journal: Circulation (2003)

Background— Rapamycin is an immunosuppressive agent with antiproliferative properties against not only lymphocytes but also vascular endothelial and smooth muscle cells, and it reduces the fibroproliferative response to vascular injury. Heme oxygenase-1 (HO-1) has also been shown to have graft protective effects and to inhibit vascular remodeling. In this study, we evaluated whether there is an interaction between rapamycin and HO-1. Methods and Results— In human pulmonary artery endothelial or smooth muscle cells, HO-1 expression was evaluated in response to rapamycin or wortmannin, an inhibitor of the upstream modulator of mammalian target of rapamycin (mTOR) PI-3K. We also evaluated whether the inhibitory actions of rapamycin on platelet-derived growth factor–dependent proliferation was mediated by HO using the chemical inhibitor tin protoporphyrin. Rapamycin induced HO-1 expression in both pulmonary endothelial and smooth muscle cells, whereas no to little increase was seen in response to another immunosuppressive agent, cyclosporin A. HO-1 expression was also increased in response to wortmannin, suggesting that the PI-3K–mTOR pathway is required for this induction. Inhibition of HO activity resulted in a loss of the antiproliferative activity of rapamycin in growth factor–stimulated smooth muscle cells. Conclusions— The induction of HO-1 expression by rapamycin and, more importantly, the effects of tin protoporphyrin, an inhibitor of HO activity, on the antiproliferative actions of rapamycin suggest that the effects of rapamycin may be, at least in part, modulated by its actions on HO-1.
Influence of Cyclophosphamide on Homograft Rejection
Authors: Gerald L. Brody
Journal: JAMA (1965)

Earlier work<sup>1</sup>has shown that cyclophosphamide (Cytoxan) significantly prolongs survival of skin homografts in rabbits. This appears to be a direct and specific effect of the drug upon the immune mechanism and not a nonspecific inhibition arising from a toxic state of the animals. The following is a report of a histological study of skin homografts exchanged between dissimilar strains of rabbits, comparing the rejection response between animals receiving cyclophosphamide and those which received no drug <h3>Methods and Material</h3> Standard, measured patches of full-thickness skin on the ears were exchanged between California and New Zealand strains of adult male rabbits weighing 2 to 3 kg. Two patches, each 3/4 inch square, were exchanged between each pair of rabbits, so that each rabbit bore two patches of homograft skin from his opposite strain partner on the dorsum of his left ear. Group 1 (control) animals received no drug. Group 2
Pasireotide is more effective than octreotide in reducing hepatorenal cystogenesis in rodents with polycystic kidney and liver diseases
Authors: Tatyana V. Masyuk, Brynn N. Radtke, Angela J. Stroope, Jesús M. Banales, Sergio A. Gradilone, Bing Huang, Anatoliy I. Masyuk, Marie C. Hogan, Vicente E. Torres, Nicholas F. LaRusso
Journal: Hepatology (2012)

In polycystic liver (PLD) and kidney (PKD) diseases, increased cyclic adenosine monophosphate (cAMP) levels trigger hepatorenal cystogenesis. A reduction of the elevated cAMP by targeting somatostatin receptors (SSTRs) with octreotide (OCT; a somatostatin analog that preferentially binds to SSTR2) inhibits cyst growth. Here we compare the effects of OCT to pasireotide (PAS; a more potent somatostatin analog with broader receptor specificity) on: (1) cAMP levels, cell cycle, proliferation, and cyst expansion in vitro using cholangiocytes derived from control and PCK rats (a model of autosomal recessive PKD [ARPKD]), healthy human beings, and patients with autosomal dominant PKD (ADPKD); and (2) hepatorenal cystogenesis in vivo in PCK rats and Pkd2(WS25/-) mice (a model of ADPKD). Expression of SSTRs was assessed in control and cystic cholangiocytes of rodents and human beings. Concentrations of insulin-like growth factor 1 (IGF1) and vascular endothelial growth factor (VEGF) (both involved in indirect action of somatostatin analogs), and expression and localization of SSTRs after treatment were evaluated. We found that PAS was more potent (by 30%-45%) than OCT in reducing cAMP and cell proliferation, affecting cell cycle distribution, decreasing growth of cultured cysts in vitro, and inhibiting hepatorenal cystogenesis in vivo in PCK rats and Pkd2(WS25/-) mice. The levels of IGF1 (but not VEGF) were reduced only in response to PAS. Expression of SSTR1 and SSTR2 (but not SSTR3 and SSTR5) was decreased in cystic cholangiocytes compared to control. Although both OCT and PAS increased the immunoreactivity of SSTR2, only PAS up-regulated SSTR1; neither drug affected cellular localization of SSTRs.PAS is more effective than OCT in reducing hepatorenal cystogenesis in rodent models; therefore, it might be more beneficial for the treatment of PKD and PLD.
Current Medical Practice and the Food and Drug Administration
Authors: Gregory R. Mundy
Journal: JAMA (1974)

The manner of use of three prescription drugs for hospitalized patients (cephalexin, allopurinol, and propranolol hydrochloride) was compared with the labeling recommendations that are approved by the Food and Drug Administration (FDA). Each drug was prescribed frequently for therapeutic indications not mentioned in the approved labeling (cephalexin in 78.3% of cases, allopurinol in 57.1%, and propranolol in 64.7%). Thus, a gap has developed between current medical practice and FDA-approved recommendations for therapeutic use. We suggest that for cephalexin and allopurinol, the FDA-approved recommendations agreed with the current medical literature, and the prescribing habits of physicians were inappropriate. With propranolol, however, the FDA-approved recommendations were lagging behind both good medical practice and the current medical literature. The implications of these findings are discussed with respect to prescribing habits and drug regulation. (<i>JAMA</i>229:1744-1748, 1974)
An acquaintance renewed
Authors: P. Rubin, G. Phillips
Journal: BMJ (1996)

Our doctor was away and it was the locum who came. The first I can remember was when I got to hospital, the argument going on above my head: mum to one side, a nurse on the other, and the 4 year old that I was lying on a hospital trolley. I remember being carried back into the ambulance: the curved rear doors and the street lights of the Cornish town seen through dark windows as we drove home. But …
Benign postinfection polymyositis.
Authors: M S Schwartz, M Swash, M Gross
Journal: BMJ (1978)

Six patients developed persistent muscular cramps, aching pain, and fatigability after an influenza-like illness. Electromyography showed myopathic changes, although results of routine laboratory investigations were normal in all but one patient, whose serum creatine kinase concentration was slightly increased. All but one of the patients improved: three were asymptomatic within one to two years. The syndrome was probably a benign form of polymyositis.
MICROBIC VIRULENCE AND HOST SUSCEPTIBILITY IN PARATYPHOID-ENTERITIDIS INFECTION OF WHITE MICE
Authors: Ida W. Pritchett
Journal: The Journal of Experimental Medicine (1925)

Seasonal variations are described in the response of five strains of mice to inoculation with the Type II bacillus of mouse typhoid (Bacillus pestis caviae). There occurred in the case of all strains a high peak of mortality during the spring, a lower death rate during the summer, and a subsequent autumn rise in the number of deaths.
Has Edson Scooped the Record?
Authors: J. F. Jenkins
Journal: JAMA (1896)

Tecumseh, Mich., Feb. 18, 1896. <h3>To the Editor:</h3> —The following clipping is taken from the Detroit<i>Pree Press</i>and certainly speaks very plainly for itself: "To Physicians in Regular Practicewill be sent free by mail a sample bottle of Dr. Edson's Aseptolin, the new discovered treatment for consumption, etc., together with Dr. Edson's paper, reprinted from the New York<i>Medical Record</i>of Feb. 8, 1896. Those who have patients suffering from consumption are urged to test this remedy. None but physicians can use it. Address, etc., etc." We are living in a decidedly fast age. Respectfully,
The hepatic stem cell niche: Identification by label-retaining cell assay
Authors: Reiichiro Kuwahara, Alexander V. Kofman, Charles S. Landis, Scott E. Swenson, Els Barendswaard, Neil D. Theise
Journal: Hepatology (2008)

Label retention assays remain the state-of-the-art approach to identify the location of intraorgan epithelial stem cell niches, in situ and in vivo . They are commonly used in organs with rapid cell turnover but have not been applied to the liver, where cell turnover is very slow. We used a sublethal dose of acetaminophen administered coincident with bromodeoxyuridine to load possible hepatic stem cells in mice with label and then administered a second, sublethal chase of acetaminophen to accomplish “washout” of label from transit amplifying cell populations. Conclusion: Four possible hepatic stem cell niches are identified by this approach: the canal of Hering (proximal biliary tree), intralobular bile ducts, periductal “null” mononuclear cells, and peribiliary hepatocytes. These results confirm several different and often contradictory lines of investigation regarding the intrahepatic location of stem/progenitor cells and suggest that the liver has a multi-tiered, flexible system of regeneration rather than a single stem/progenitor cell location.
Reduction of catheter-associated sepsis in parenteral nutrition using low-dose intravenous heparin.
Authors: M J Bailey
Journal: BMJ (1979)

To assess whether adding low-dose heparin to the infusate of patients receiving parenteral nutrition reduced the incidence of septic complications related to the central venous catheter, 80 consecutive patients requiring intravenous feeding were studied. Half of these patients received heparin 1 unit/ml of infusate, while in the remaining 40 (controls) an equal volume of physiological saline was added to the infusate. Strict criteria for the management of the indwelling CVC were observed. The catheter tips were cultured after removal: only one was infected in the heparin group compared with nine in the control group. This significant reduction may have been due to the heparin preventing a fibrin sleeve from forming around the catheter tip. It is recommended that, as well as observing the usual aseptic precautions in managing the cannula, 500 units of heparin are added to each 500 ml of fluid infused to reduce the incidence of catheter-associated sepsis.
Angiography in Hemoglobin S-C Disease
Authors: KODURI R.P. RAO
Journal: Annals of Internal Medicine (1986)

Letters and Corrections1 December 1986Angiography in Hemoglobin S-C DiseaseKODURI R.P. RAO, M.D.KODURI R.P. RAO, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-105-6-971_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Radiographic contrast media have been reported to cause morphologic "sickling" in vitro of erythrocytes containing hemoglobin S (1). However, complications from angiography in patients with sickle cell disease have been rare (2). The clinical relevance and the significance of the in-vitro observations are unclear (3), but nevertheless, it is recommended that patients with sickle cell anemia be given transfusions before angiography to lower the hemoglobin S level to an arbitrarily set value (4). Whether these recommendations should be applied to patients with hemoglobin S-C disease is not clear.Before 1983, eight angiographic procedures had been done in...References1. PERILLIEEPSTEIN PF. Sickling phenomenon produced by hypertonic solutions: a possible explanation for the hyposthenuria of sicklemia. J Clin Invest. 1963;42:570-80. CrossrefMedlineGoogle Scholar2. RICHARDSNULSEN DF. Angiographic media and the sickling phenomenon. Surg Forum. 1971;22:403-4. MedlineGoogle Scholar3. MURPHYWENGARDBRERETON JMW. Rheological studies of Hb SS blood: influence of hematocrit, hypertonicity, separation of cells, deoxygenation, and mixture with normal cells. J Lab Clin Med. 1976;87:475-86 MedlineGoogle Scholar4. STOCKMANNIGROMISHKINOSKI JMMF. Occlusion of large cerebral vessels in sickle-cell anemia. N Engl J Med. 1972;287:846-9. CrossrefMedlineGoogle Scholar5. RAOLEE KM. Risks associated with angiography in patients with sickle cell disease. Radiology. 1983;147:600-1. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Cook County Hospital Chicago, IL 60612 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByThe Acute Chest Syndrome of Sickle Cell Disease 1 December 1986Volume 105, Issue 6Page: 971-971KeywordsAnemiaAngiographyHemoglobinSickle cell disease Issue Published: 1 December 1986 PDF DownloadLoading ...
Coal-Oil as a Medicinal Agent
Authors: J. Mulvany
Journal: BMJ (1869)

COAL-OIL, as an illuminiatinig agent, has been in use from the most re- mote anitiquity.iAleltioni is made of it in the writings of Ilerodotus and Pliny.Its name, petroleum, wx as given to it on account of its being found issuing fromii crevices in the rocks in Agrigentum, Zante, Persia, etc.Its mnore modern and less classic designation, coal-oil, xvas given to it on the stipposition that it is produced by a subterranean de- structive distillationi of coal, effected by means of the internal heat of the earth.Wlhetlher this tlhcory or its converse-viz., that coal is formed from petioleun ho-ldol good, is a subject worthy of the attentioin which it at the pr eseut moment excites, but one in no wvay bearing on the subject of the lreseut paper.It may not, however, be irrelevant to state, that petroleumin is niow uiniversally considered to be the result of a sloW process of decomposition of the woody fibre of plants, and, in a minor degree, of the tissues of the loxver animials; that it is found issu- ing from the soil in arious parts of Canada, and exuding copiously from the Devonaian saind-stones, in several states of the great Republic, soutlh of the Nexw Dol)iniolu, and in conniection xvith limestonie and rocks of all agcs, IPakeoioic, Lower Siluriani, and others, up to the ter- tiary period.As it issues fiiom the "'springs," it is unfit for eitlher lighting or medicinial purlposes.Although used by the Indians as an external applicationi, the hy(liocaihons wxith xxhiclh it remains clharged-naphtha, benzole, benzinc, etc. -ren(lci its application exceedingly risky; high inflamimliation, and(i eveni mortification, hiaving resulted from its incautious application to ahia(lde(l surfaces.For miiedicinal purposes, tlherefore, oil of grcat purity slhXld b)e piocured.As a general rule, that refined ill Canada will bie fotuund stufficienitly fiee from impurities, the temptation to adulterate it itlh the miiore s-olatile lhydrocarbonis being comparatively sliglht, oni accotiuit of the muticlh smaller demand for it for exportation, and the vast iunemcr of coal-oil xw ells in the dominion.iN hen pure,
Lytic bone metastases after APD in breast carcinoma.
Authors: M. R. Williams, M. P. Mohajer
Journal: BMJ (1988)

and not be limited to conventions.Classical power determination does use a single alternative hypothesis, but power of the test is even greater if the true difference is larger than the posited clinically important difference.We think that Bayesian approaches offer great potential.As presently developed, however, the Bayesian method is difficult even for Bayesian statisticians and requires more research before it becomes practical.Development of Bayesian in- ference instruments that are easily employed by clinicians would greatly advance the usefulness of the Bayesian approach.
Clinical Use of Renin Determinations
Authors: Victor Vertes
Journal: JAMA (1974)

INCREASED awareness and understanding of the relationships between the individual components of the reninangiotensin-aldosterone system and its role in benign essential hypertension have revolutionized the diagnosis and clinical management of hypertension. Polite but serious controversy continues between the proponents of the importance of the renin-angiotensin-aldosterone system in the classification of the various types of benign essential hypertension and those who see limited application of the system in clinical practice. Differences in methods used, failure to distinguish between plasma renin activity (PRA) vs renin concentration, and failure to take into consideration the clinical status of the patient when testing is performed are some reasons for varying conclusions by clinicians in their attempts to classify hypertension into low-, normal-, and high-renin states. Nevertheless, once the pitfalls are identified and compensated for, accurate measurement of PRA—and classification of hypertension into low- and high-renin states—may be of considerable value in the diagnosis, prognosis, and
Tampons and Toxic Shock Syndrome
Authors: Merlin S. Bergdoll
Journal: JAMA (1984)

To the Editor.—  I was disturbed by the article on toxic shock syndrome (TSS), Holdup of Toxic Shock Data Ends During Trial in Texas, particularly the title and the first paragraph, in which it was suggested that we suppressed scientific data. 1 The reporter who wrote the article in question did call me about the data, and I thought I had explained to him why they had not been published. We, of course, have the sole right to release these data. Faculty at the University of Wisconsin do not accept support for research unless they have complete control of the results of the studies and can publish them at their discretion. This is done when the studies are complete and sound conclusions can be drawn. Sometimes it will take many months, if not years, before adequate information is available for publication. In the case of the tampon work, accumulation of
Impact of Intensive Educational Approach to Dietary Change in NIDDM
Authors: Lesley V Campbell, Renate Barth, Jill K Gosper, Jim J Jupp, Leon A Simons, Donald J Chisholm
Journal: Diabetes Care (1990)

The aim of this study was to compare the effects of an intensive educational approach incorporating longer time, greater simplicity, repetition, and cognitive motivational techniques with a conventional one in subjects with established non-insulin-dependent diabetes mellitus (NIDDM) whose weight, glycemic control, and diet were not optimal. Subjects were randomly allocated to intensive or conventional education. Of 350 subjects, 70 met the study criteria, which included established NIDDM (greater than or equal to 3 mo), suboptimal recent glycemic control, dietary fat intake greater than or equal to 35% of total energy intake, and body mass index greater than or equal to 25 kg/m2. The intensive approach was associated with significantly greater improvements in dietary compliance, dietary intake (complex carbohydrate, [P = 0.013], legumes [P less than 0.0001], fiber [P less than 0.0001], total fat [P less than 0.004], saturated fat [P less than 0.004]), and total cholesterol level (P = 0.007). The transient improvement in glycemic control was similar in both groups. An intensive education program can improve dietary compliance in established NIDDM subjects more than a conventional one. These recommended dietary improvements achieve better improvement in total cholesterol but do not necessarily improve glycemic control.
Narrative Review: Tetanus—A Health Threat After Natural Disasters in Developing Countries
Authors: Majid Afshar, Mahesh Raju, David Ansell, Thomas P. Bleck
Journal: Annals of Internal Medicine (2011)

Tetanus is an expected complication when disasters strike in developing countries, where tetanus immunization coverage is often low or nonexistent. Collapsing structures and swirling debris inflict numerous crush injuries, fractures, and serious wounds. Clostridium tetani infects wounds contaminated with dirt, feces, or saliva and releases neurotoxins that may cause fatal disease. Clusters of infections have recently occurred after tsunamis and earthquakes in Indonesia, Kashmir, and Haiti. The emergency response to clusters of tetanus infections in developing countries after a natural disaster requires a multidisciplinary approach in the absence of an intensive care unit, readily available resources, and a functioning cold-chain system. It is essential that injured people receive immediate surgical and medical care of contaminated, open wounds with immunization and immunoglobulin therapy. Successful treatment of tetanus depends on prompt diagnosis of clinical tetanus, treatment to ensure neutralization of circulating toxin and elimination of C. tetani infection, control of spasms and convulsions, maintenance of the airway, and management of respiratory failure and autonomic dysfunction.