tbuckley/cabot-search huggingface dataset:
Heparin Dosage and Clotting Time
Authors: VICTOR GUREWICH
Journal: Annals of Internal Medicine (1974)

Comments and Correction1 October 1974Heparin Dosage and Clotting TimeVICTOR GUREWICH, M.D., F.A.C.P., BOGUSLAW LIPINSKI, PH.D.VICTOR GUREWICH, M.D., F.A.C.P.Search for more papers by this author, BOGUSLAW LIPINSKI, PH.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-81-4-567 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The report of Klein and Bell (Ann Intern Med 80:477-481, 1974) of disseminated intravascular coagulation occurring during heparin therapy is an important reminder of the inadequate state of our knowledge of this important syndrome. The need for a controlled study of the use of heparin in this syndrome may indeed be evident, as they state, but first it will be necessary to standardize our methods for controlling heparin therapy.Clotting time is the accepted and rational guide to heparin dosage in venous thromboembolic disease, but it may be an inadequate and meaningless guide in disseminated intravascular coagulation....References1. GODALABILGAARD HU: Gelation of soluble fibrin by ethanol. Scand J Haematol 3:342-350, 1966 CrossrefMedlineGoogle Scholar2. GUREWICHHUTCHINSON VE: The detection of intravascular coagulation by a serial-dilution protamine sulfate test. Ann Intern Med 75:895-902, 1971 LinkGoogle Scholar3. GUREWICHLIPINSKILIPINSKA VBI: Comparative study of precipitation and paracoagulation by protamine sulfate and ethanol gelation tests. Thrombosis Research 2:539-556, 1973 CrossrefGoogle Scholar4. MÜLLER-BERGHAUSHOCKE GM: Effect of endotoxin on the formation of microthrombi from circulating fibrin monomer complexes in the absence of thrombin generation. Thrombosis Research 1:541-548, 1972 CrossrefGoogle Scholar5. LIPINSKIGUREWICHNOWAK BVA: The effect of heparin and dipyridamole on the deposition of fibrin-like material in rabbits infused with soluble fibrin monomer or fibrinogen. Thrombosis Research. In press, September 1974 CrossrefGoogle Scholar1. MERSKEY C: Defibrination syndrome or . . .? Blood 41:599-603, 1973 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Vascular Laboratory Lemuel Shattuck Hospital Boston, Massachusetts 02130 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 October 1974Volume 81, Issue 4Page: 567-568KeywordsDisseminated intravascular coagulationHeparinMetastasis ePublished: 1 December 2008 Issue Published: 1 October 1974 PDF downloadLoading ...
Curschmann Spirals in Cervical Mucus
Authors: JOÃO CARLOS PROLLA
Journal: Annals of Internal Medicine (1974)

Comments1 May 1974Curschmann Spirals in Cervical MucusJOÃO CARLOS PROLLA, M.D.JOÃO CARLOS PROLLA, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-80-5-674 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The finding of Curschmann spirals by microscopic examination of sputum is generally considered to be almost pathognomonic of bronchial asthma, by most textbooks of clinical laboratory diagnosis, and even by a recent review on the constituents of sputum published by the ANNALS OF INTERNAL MEDICINE (1). They have been considered to be bronchiolar casts of twisted inspissated mucus. These two ideas are far from true.The facts are that: [1] Curschmann spirals are a frequent (almost universal) nonspecific finding in the sputum of smokers, as shown by Fullmer and colleagues (2) and Walker and Fullmer (3); and...References1. EPSTEIN R: Constituents of sputum: a simple method. Ann Intern Med 77:259-265, 1972 LinkGoogle Scholar2. FULLMERSHORTALLEN CJA: Sputum of chronic cigarette smokers. Rocky Mt Med J 66:42-46, 1969 MedlineGoogle Scholar3. WALKERFULLMER KC: Progress report on study of respiratory spirals. Acta Cytol (Baltimore) 14:396-398, 1970 MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Cytology Laboratory Hospital de Clínicas de Porto Alegre Porto Alegre-RS-Brasil PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByCurschmann's spirals in sputum of subjects exposed daily to urban environmental pollutionCurschmann Spirals in the VaginaRUI LUZZATTO, M.D., SONIA R. MACIEL, C.T. 1 May 1974Volume 80, Issue 5Page: 674-675KeywordsAsthmaClinical laboratoriesMucusSputum Issue Published: 1 May 1974 PDF DownloadLoading ...
Tenoxicam, a non-steroid anti-inflammatory drug, is unable to increase the response rate in patients with chronic hepatitis C treated by alpha interferon
Authors: Jean-Pierre Zarski, Marianne Maynard-Muet, Suzanne Chousterman, Maryline Baud, Raphaëlle Barnoud, Armand Abergel, Yannick Bacq, Jean-Marc Combis, Xavier Causse, Albert Tran, Frédéric Oberti, Anne Minello, Solange Bresson-Hadni, François Bailly, Jean-Jacques Raabe, Vincent Leroy, Lynda Hamici, Tariq Hicham, Marie-France St Marc Girardin
Journal: Hepatology (1998)

The purpose of this study is to compare a combination of interferon (IFN)-alpha2a (Roferon) + Tenoxicam with IFN-alpha2a alone in the treatment of chronic hepatitis C. This prospective, randomized double-blind study included 149 patients, all of whom were diagnosed with active chronic hepatitis C but non-cirrhotic (ALT > or = 1.5 upper limit of normal, anti-hepatitis C virus (HCV) positive by enzyme-linked immunosorbant assay2 and RIBA3). The patients were randomized in two groups, as follows: G1 (n = 76): IFNalpha2a 3 million units times per week during 6 months + placebo; and G2 (n = 73): IFNalpha2a 3 million units three times per week + Tenoxicam (20 mg/day) during 6 months. Alanine aminotransferase (ALT) and HCV RNA were determined before and at months 6 and 12 of treatment. 2'5' oligoadenylate synthetase activity (2'5' AS) was dosed in mononuclear cells before and at 3-month treatment intervals in 28 patients. Liver biopsy was performed before and 6 months after the end of therapy. Parameters were similar before therapy for both groups. Biochemical and virological responses were similar for both groups at month 6 (49.3% vs. 42.9% and 43.3% vs. 38.3%, respectively) and month 12 (28.3% vs. 23.8% and 17.2% vs. 17.5%, respectively). HCV RNA level significantly decreased in both groups at month 6, with no difference whatever the therapy; however, the HCV RNA level returned to initial values at month 12 and was the only significant prognostic factor of a sustained response. No peak of 2'5' AS activity was observed during treatment in patients with dual therapy. A histological improvement was also noted in both groups without difference, regardless of therapy. The percentage of adverse events was identical for both groups. Paracetamol intake, assessed in 80 patients, was 49.1 g per 6 months in the G1 group and 22.5 g per 6 months in the G2 group (not significant). In conclusion, the non-steroid anti-inflammatory drug, Tenoxicam, does not increase IFNalpha efficacy in the treatment of chronic hepatitis C. This combination is well tolerated and partially lowers Paracetamol intake, but not preexisting alpha-IFN adverse events.
Management of Hip Disorders in Children
Authors: Phillip G. Spiegel
Journal: JAMA (1983)

This 284-page, multiauthored book states as its avowed purpose, an approach to designing surgical and nonsurgical treatment programs for individual patients based on the pathophysiologic nature of their specific orthopedic conditions.  The reader is prepared for this purpose beginning with the first four chapters on development and growth of the hip, including its vascularity, the femoral growth plate, and patterns of deformity of the developing hip. Succinctly, with clarity and only a little overlap, a fundamental understanding of the child's hip is well presented. The next nine chapters are on fractures, slipped femoral capital epiphysis, infections, congential dislocation of the hip, Legg-Calve-Perthes disease, cerebral palsy, myelomeningocele, arthrogryposis, and congenital abnormalities of the femur. These chapters are uneven in quality, best succeeding when there is a personal experience by the author and not merely a literature review. The last chapter on principles of management is interesting but contributes little in comparison
Inducing hypothermia after out of hospital cardiac arrest
Authors: S. Bernard
Journal: BMJ (2014)

Latest large trials provide no support for this intervention

Out of hospital cardiac arrest is common and is associated with a high rate of mortality.1 With early ambulance treatment, about 30% of these patients have a return of spontaneous circulation and are transported to hospital. However, many patients remain comatose owing to hypoxic brain injury, and this is the leading cause of death after hospital admission.

Over the past decade, there has been considerable interest in the use of therapeutic hypothermia, where patients are cooled to a target temperature of 32-34°C and this temperature is maintained for 12-24 hours. This approach is based on the results of two clinical trials published in 2002.2 3

More recently, a larger trial compared a target temperature of 36°C with that of 33°C.4 The Targeted Temperature Management (TTM) trial randomised 939 patients who remained comatose after resuscitation from out of hospital cardiac arrest at hospitals in Europe and Australia. The primary outcome measure was all cause mortality at the end of the trial. Overall, 50% of the patients in the group allocated to 33°C for 24 hours died compared with 48% of those allocated to the 36°C group (hazard ratio 1.06, 95% confidence interval 0.89 to 1.28; …
Efficacy and Effectiveness of Antidepressants: Current Status of Research
Authors: H. Edmund Pigott, Allan M. Leventhal, Gregory S. Alter, John J. Boren
Journal: Psychotherapy and Psychosomatics (2010)

This paper examines the current status of research on the efficacy and effectiveness of antidepressants.This paper reviews four meta-analyses of efficacy trials submitted to America's Food and Drug Administration (FDA) and analyzes STAR*D (Sequenced Treatment Alternatives to Relieve Depression), the largest antidepressant effectiveness trial ever conducted.Meta-analyses of FDA trials suggest that antidepressants are only marginally efficacious compared to placebos and document profound publication bias that inflates their apparent efficacy. These meta-analyses also document a second form of bias in which researchers fail to report the negative results for the pre-specified primary outcome measure submitted to the FDA, while highlighting in published studies positive results from a secondary or even a new measure as though it was their primary measure of interest. The STAR*D analysis found that the effectiveness of antidepressant therapies was probably even lower than the modest one reported by the study authors with an apparent progressively increasing dropout rate across each study phase.The reviewed findings argue for a reappraisal of the current recommended standard of care of depression.
Selective RNA editing and subunit assembly of native glutamate receptors
Authors: Ralph B. Puchalski, Jean-Claude Louis, Nils Brose, Stephen F. Traynelis, Jan Egebjerg, Valery Kukekov, Robert J.Wenthold, Scott W. Rogers, Fan Lin, Thomas Moran, John H. Morrison, Stephen F. Heinemann
Journal: Neuron (1994)
Comment re: Preclinical Model of Spontaneous Melanoma Metastasis
Authors: William Cruz-Munoz, Robert S. Kerbel
Journal: Cancer Research (2009)

In Response: 

Dr. Hoffman is correct to highlight his previous work showing detection of spontaneous human melanoma brain metastases by using imaging-based techniques. Indeed, we cited one of his articles ( [1][1]) mentioned in his letter as reference 16 in our Clinical Cancer Research article. We
IgE antibody to <i>Aspergillus fumigatus</i> recombinant allergens in cystic fibrosis patients with allergic bronchopulmonary aspergillosis
Authors: A. P. Knutsen, P. S. Hutcheson, R. G. Slavin, V. P. Kurup
Journal: Allergy (2004)

Allergic bronchopulmonary aspergillosis (ABPA) in cystic fibrosis (CF) is characterized by a heightened Th2 CD4+ T-cell response to Aspergillus fumigatus (Af) allergens and a hyper-immunoglobulin E (IgE) state compared with cystic fibrosis patients without ABPA. The IgE serologic differentiation of ABPA from atopic CF patients can be difficult. We propose as the reactivity with purified antigens varies qualitatively and quantitatively and that the antibody response is more specific than with crude Af antigen extract, the IgE responses to purified recombinant Af allergens may differentiate ABPA from atopic CF patients.Serum IgE reactivity to seven recombinant purified allergens and to a crude extract of Af was measured in 15 ABPA, in 23 Af skin test positive (ST+), and in 19 Af skin test negative (ST-) CF patients. Four of the ABPA CF patients were studied before and after developing ABPA. Nine ABPA patients were studied during flares and remissions of ABPA.Allergic bronchopulmonary aspergillosis patients had significantly increased IgE reactivity to Asp f2, f3, f4, f6, and f16 compared with the Af ST+ and ST- non-ABPA CF patients. In the ABPA patients studied before and after developing ABPA, IgE reactivity also increased to Asp f2, f3, f4, and f6, and to the crude extract. In ABPA CF patients, IgE reactivity to Asp f1, f2, f3, and f6 significantly increased during periods of ABPA flares compared with periods of remission. Analysis of the receiver operating curve demonstrated that IgE reactivity to Asp f3 and f4 gave the best sensitivity and specificity and were better than IgE reactivity to a crude extract of Aspergillus. Furthermore, in ABPA patients studied during periods of remission the IgE reactivity to Asp f3 and f4 remained significantly elevated compared with Af ST+ non-ABPA patients. The IgE responses when considered either to be positive or negative to Asp f3 and f4 significantly differentiated ABPA from Af ST+ and ST- non-ABPA CF patients. In contrast, IgE reactivity was considered positive to the crude extract in 89% of ABPA, 61% of Af ST+, and 0% of Af ST- non-ABPA CF patients.Immunoglobulin E reactivity to a panel of purified Af allergens, especially to Asp f3 and f4, differentiates ABPA from atopic Af ST+ non-ABPA CF patients. Serial determinations of IgE reactivity to individual purified Aspergillus antigens, especially Asp f3, demonstrates that increases in IgE reactivity may provide improved distinction between stages of flares and remission compared with changes in IgE reactivity to a crude Aspergillus extract.
Kinetics and Metabolic Activity of Biosynthetic NPH Insulin Evaluated by the Glucose Clamp Technique
Authors: M Massi Benedetti, A Bueti, D Mannino, G Bellomo, M A Antonella, G Calabrese, G Zega, P Brunetti
Journal: Diabetes Care (1984)

The glucose clamp technique has been used to evaluate the metabolic activity of NPH biosynthetic insulin in diabetic subjects free from anti-insulin antibodies. After overnight blood glucose normalization with a glucose-controlled insulin infusion system (Biostator), an s.c. injection of NPH insulin was given in the abdominal region. The insulin dose (0.236 ± 0.05 U/kg body wt) was related to the usual intermediate-acting insulin requirement in the morning. Glucose was clamped at 100 mg/dl by a feedback i.v. glucose infusion. The end of the action of s.c. injected insulin considered conventionally to be the time of the spontaneous rise of blood glucose to 110 mg/dl. Free insulin levels were higher and the length of action was longer after NPH porcine than after NPH biosynthetic human insulin (BHI) (area under the free insulin curve: porcine 1423 ± 556 mU/L/h; BHI 1045 ± 338 mU/L/h, P &amp;lt; 0.05; length of action: porcine 16.0 ± 3.2 h; BHI 13.7 ± 0.9 h, P &amp;lt; 0.05); the glucose requirement was higher after porcine (76.8 ± 13.5 g) than after BHI (58.5 ± 14.6 g) without reaching statistical significance. However, the metabolic activity of the bioavailable insulin (index of plasma free insulin activity) was similar for the two insulins (porcine 381 ± 77.4, BHI 342.8 ± 54.2 mU/L/g of glucose/h). We conclude that a difference in pharmacokinetics exists between NPH BHI and porcine NPH insulin, which makes the latter metabolically more active. The different behavior does not seem to be related to the insulin molecule itself but could be a consequence of the unequal content of protamine in the two pharmacologic preparations.
Learning Theories and Medical Lectures: Add Little to Little and There Will Be a Big Pile
Authors: Kirsti R. Dyer
Journal: JAMA (1989)

<h3>To the Editor. —</h3> I thoroughly enjoyed reading the commentary by Dr Cook.<sup>1</sup>As a medical student, I have found at least one instructor representative of each theory. However, one type of lecturer, whom I have encountered on numerous occasions, was not described. This is the practitioner of the exhumation theory. Practitioners of this method believe that all medical students have an unlimited amount of time, energy, and interest; that this is the only course worthy of a lifetime pursuit; and, of course, that medical school is the student's entire life. Lecturers assume that students will have the passion to dig down into, and eagerly wade through, multiple layers of minutiae to unearth, on their own, a few deeply buried pearls of wisdom. These pearls often appear so small and insignificant that they are readily overlooked. The first problem with this method is the failure of the instructor to
Lung gene therapy with highly compacted DNA nanoparticles that overcome the mucus barrier
Authors: Jung Soo Suk, Anthony J. Kim, Kanika Trehan, Craig S. Schneider, Liudmila Cebotaru, Owen M. Woodward, Nicholas J. Boylan, Michael P. Boyle, Samuel K. Lai, William B. Guggino, Justin Hanes
Journal: Journal of Controlled Release (2014)
Tacrolimus‐associated posterior reversible encephalopathy syndrome in hematopoietic allogeneic stem cell transplantation
Authors: Aimee E. Hammerstrom, Joshua Howell, Alison Gulbis, Gabriela Rondon, Richard E. Champlin, Uday Popat
Journal: American Journal of Hematology (2013)

Tacrolimus-associated posterior reversible encephalopathy syndrome (PRES) is a potential complication of allogeneic stem cell transplant (SCT). Due to the paucity of information on the management of PRES in SCT patients receiving tacrolimus, more information is needed on trends associated with the incidence of PRES and to characterize its management. A retrospective review was conducted of patients receiving tacrolimus for prevention of graft versus host disease (GVHD) after allogeneic SCT who developed PRES from September 2008 to July 2011. Nineteen patients were identified. Altered mental status, seizures, and visual abnormalities were experienced by 78.9%, 52.6%, and 31.5% of the patients, respectively, at time of PRES onset. Compared with baseline, patients with PRES were likely to have an increase in mean arterial pressure (P < 0.0001) and serum creatinine. Elevated tacrolimus levels and hypomagnesemia were not observed with PRES onset. Tacrolimus was managed in three general strategy groups: not held, held then continued, and switched to another agent. Survival was defined as survival to discharge from PRES hospitalization. When tacrolimus was not held, held then continued, or switched to another agent, 40% (2 of 5), 40% (4/10), and 50% (2/4) survived to discharge, respectively. PRES was associated with high blood pressure and adequate blood pressure control should be part of its management. No management strategy pertaining to tacrolimus usage appeared more beneficial over another.
New Intra-arterial Drug Delivery System for the Treatment of Liver Cancer: Preclinical Assessment in a Rabbit Model of Liver Cancer
Authors: Kelvin Hong, Afsheen Khwaja, Eleni Liapi, Michael S. Torbenson, Cristos S. Georgiades, Jean-Francois H. Geschwind
Journal: Clinical Cancer Research (2006)

Abstract Background: In the fight against cancer, new drug delivery systems are attractive to improve drug targeting of tumors, maximize drug potency, and minimize systemic toxicity. We studied a new drug delivery system comprising microspheres, with unique properties allowing delivery of large amounts of drugs to tumors for a prolonged time, thereby decreasing plasma levels. Liver tumors, unlike nontumorous liver, draw most of their blood supply from the hepatic artery. Exploiting this property, we delivered drug-eluting microspheres/beads (DEB) loaded with doxorubicin, intra-arterially, in an animal model of liver cancer (Vx-2). Purpose: The purpose of our study was to determine the pharmacokinetics and tumor-killing efficacy of DEB. Results: Our results show that plasma concentration of doxorubicin was minimal in the animals treated with DEB at all time points (0.009-0.05 μmol/L), suggesting high tumor retention of doxorubicin. This was significantly lower (70-85% decrease in plasma concentration) than control animals treated with doxorubicin intra-arterially. Within the tumor, doxorubicin concentration peaked at 3 days (413.5 nmol/g), remaining high to 7 days (116.7 nmol/g) before declining at 14 days (41.76 nmol/g), indicating continuous doxorubicin elution from beads. In control animals, peak tumor concentration of doxorubicin was 0.09 nmol/g. Tumor necrosis (approaching 100%) was greatest at 7 days, with minimal adverse local side effects reflected in liver function tests results. The plasma concentration of doxorubicinol (doxorubicin main metabolite) was minimal. Conclusions: Our results support the concept of DEBs as an effective way to deliver drugs to tumor. This new technology may prove to be a useful weapon against liver cancer.
Population health impact and cost-effectiveness of monitoring inactive chronic hepatitis B and treating eligible patients in Shanghai, China
Authors: Mehlika Toy, Joshua A. Salomon, Hao Jiang, Honglian Gui, Hui Wang, Jiangshe Wang, Jan Hendrik Richardus, Qing Xie
Journal: Hepatology (2013)

Inactive chronic hepatitis B (CHB) carriers make up the largest group of hepatitis B virus-infected patients, and China bears the largest total CHB burden of any country. We therefore assessed the population health impact and cost-effectiveness of a strategy of lifelong monitoring for inactive CHB and treatment of eligible patients in Shanghai, China. We used a computer simulation model to project health outcomes among a population cohort of CHB based on age-specific prevalence of hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg), and cirrhosis. Using a Markov model we simulated patients' progression through a discrete series of health states, and compared current practice to a monitor and treat (M&T) strategy. We measured lifetime costs and quality-adjusted life years (QALYs) (both discounted at 3% per year), incremental cost-effectiveness ratios (ICERs), and clinical outcomes such as development of hepatocellular carcinoma (HCC). We estimated that there are 1.5 million CHB-infected persons in Shanghai. The M&T strategy costs US$20,730 per patient and yields a discounted QALY of 15.45, which represents incremental costs and health benefits of US$275 and 0.10 QALYs compared to current practice, and an ICER of US$2,996 per QALY gained. In the base case, we estimated that the M&T strategy will reduce HCC and CHB-related mortality by only around 1%. If variables such as adherence to monitoring and treatment could be substantially improved the M&T strategy could reduce HCC by 70% and CHB-related mortality by 83%.Lifelong monitoring of inactive CHB carriers is cost-effective in Shanghai according to typical benchmarks for value for money, but achieving substantial population-level health gains depends on identifying more CHB-infected cases in the population, and increasing rates of treatment, monitoring, and treatment adherence.