tbuckley/cabot-search huggingface dataset:
Polymerase Chain Reaction for Diagnosis of HIV Infection
Authors: Douglas K. Owens
Journal: Annals of Internal Medicine (1997)

Letters1 May 1997Polymerase Chain Reaction for Diagnosis of HIV InfectionDouglas K. Owens, MD, MSc, Mark Holodniy, MD, and Alan M. Garber, MD, PhDDouglas K. Owens, MD, MScVeterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304Search for more papers by this author, Mark Holodniy, MDVeterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304Search for more papers by this author, and Alan M. Garber, MD, PhDVeterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-126-9-199705010-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We thank Brown and colleagues for their comments. Their analysis highlights an important problem, both for PCR and for other diagnostic tests for HIV: the effect of the genetic diversity of HIV on sensitivity and specificity. It is possible to classify HIV-1 into two main groups, M and O, on the basis of nucleotide sequencing [1]. Strains of HIV in group M are responsible for the vast majority of infections. Nine subtypes of group M (A through I) have been described, and subtype B causes most infections in North America. The sensitivity and specificity of current enzyme immunoassays ...References1. Hu DJ, Dondero TJ, Rayfield MA, George JR, Schochetman G, Jaffe HW, et al. The emerging genetic diversity of HIV. The importance of global surveillance for diagnostics, research, and prevention. JAMA. 1996; 275:210-6. Google Scholar2. Schable C, Zekeng L, Pau CP, Hu D, Kaptue L, Gurtler L, et al. Sensitivity of United States HIV antibody tests for detection of HIV-1 group O infections. Lancet. 1994; 344:1333-4. Google Scholar3. Identification of HIV-1 group O infection-Los Angeles County, California, 1996. MMWR Morb Mortal Wkly Rep. 1996; 45:561-5. Google Scholar4. Owens DK, Holodniy M, McDonald TW, Scott J, Sonnad S. A metaanalytic evaluation of the polymerase chain reaction for the diagnosis of HIV infection in infants. JAMA. 1996; 275:1342-8. Google Scholar Author, Article, and Disclosure InformationAffiliations: Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1997Volume 126, Issue 9Page: 740KeywordsEnzyme immunoassayHIVHIV epidemiologyHIV infectionsHIV-1Molecular epidemiologyNucleotide sequencingPolymerase chain reactionReverse transcriptionSpecificity Issue Published: 1 May 1997 CopyrightCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Worldwide Variations in Colorectal Cancer
Authors: M. M. Center, A. Jemal, R. A. Smith, E. Ward
Journal: CA A Cancer Journal for Clinicians (2009)

Previous studies have documented significant international variations in colorectal cancer rates. However, these studies were limited because they were based on old data or examined only incidence or mortality data. In this article, the colorectal cancer burden and patterns worldwide are described using the most recently updated cancer incidence and mortality data available from the International Agency for Research on Cancer (IARC). The authors provide 5-year (1998-2002), age-standardized colorectal cancer incidence rates for select cancer registries in IARC's Cancer Incidence in Five Continents, and trends in age-standardized death rates by single calendar year for select countries in the World Health Organization mortality database. In addition, available information regarding worldwide colorectal cancer screening initiatives are presented. The highest colorectal cancer incidence rates in 1998-2002 were observed in registries from North America, Oceania, and Europe, including Eastern European countries. These high rates are most likely the result of increases in risk factors associated with "Westernization," such as obesity and physical inactivity. In contrast, the lowest colorectal cancer incidence rates were observed from registries in Asia, Africa, and South America. Colorectal cancer mortality rates have declined in many longstanding as well as newly economically developed countries; however, they continue to increase in some low-resource countries of South America and Eastern Europe. Various screening options for colorectal cancer are available and further international consideration of targeted screening programs and/or recommendations could help alleviate the burden of colorectal cancer worldwide.
Relationship between Response and Survival in More Than 50,000 Patients with Advanced Non-small Cell Lung Cancer Treated with Systemic Chemotherapy in 143 Phase III Trials
Authors: Katsuyuki Hotta, Yoshiro Fujiwara, Katsuyuki Kiura, Nagio Takigawa, Masahiro Tabata, Hiroshi Ueoka, Mitsune Tanimoto
Journal: Journal of Thoracic Oncology (2007)
Total orthotopic allogeneic small bowel transplantation in rats: effect of allograft irradiation combined with cyclosporine-A therapy.
Authors: R E Saat, R W de Bruin, E Heineman, J Jeekel, R L Marquet
Journal: Gut (1991)

Rejection and graft versus host disease are prominent features in small bowel allotransplantation in rats. Cyclosporine treatment of the recipient and irradiation of the donor were used to circumvent these phenomena in the WAG to brown Norway rat model. Irradiation of the donor with five or 10 Gy did prevent graft versus host disease but resulted in a more vigorous rejection of small bowel allografts in untreated recipients (mean (SEM) survival times of 11.5 (0.4) (n = 8) and 7.5 (0.9) (n = 11) days respectively, versus 16.6 (2.6) days (n = 17), p less than 0.01). Cyclosporine treatment of the recipient (25 mg/kg on days 0, 1, 2, 4, and 6 after transplantation) led to a mean (SEM) survival time of 38.3 (8.5) days (n = 10); 20% of the animals developed graft versus host disease. Combined with 5 Gy donor pretreatment, a similar survival was obtained without occurrence of graft versus host disease. However, cyclosporine treatment combined with 10 Gy led to a significant shortening of graft survival (23.1 (6.8) days, n = 9). These results suggest that although irradiation is very effective in preventing graft versus host disease, high dosages may accelerate rejection either by making the graft more vulnerable to rejection or by completely removing the immuno-suppressive effect of graft versus host disease.
'Whole gut remote endoscopy': a novel protocol for luminal imaging using combined small bowel and colon capsule endoscopy
Authors: D. Majumdar, R. Sidhu, A. J. Lobo, M. E. McAlindon
Journal: Gut (2011)

<h3>Introduction</h3> Conventional endoscopy is uncomfortable, undignified, may require sedation and incur complications. Yet most procedures provide reassurance rather than identify relevant abnormalities. A sensitive diagnostic tool which is simpler, safer, less invasive and better tolerated, is needed. Capsule endoscopy (CE) was first developed to examine the small bowel, but provides images of oesophagus and stomach, and dedicated oesophageal and colon capsule endoscopes are in use. The authors describe a novel protocol using combined CE procedures to investigate the whole gastrointestinal tract. <h3>Methods</h3> Patients had a 5 day low fibre diet and clear fluids only 12 h prior to admission. On the day of the test, they drank 2 l Kleanprep between 19:00 and 21:00. At 22:00 they swallowed a small bowel capsule (SCE). At 08:00 the following day the data recorder was detached. A new data recorder was initiated and the patient swallowed a colon capsule (CCE) followed by 2L Kleanprep. Two further doses of Fleet phospho-soda were administered and a bisacodyl suppository if the capsule was not excreted. One patient also had an oesophageal CE prior to discharge. Bowel cleanliness was described using a validated scale (1–4: excellent to poor). Results were described as median and IQR. <h3>Results</h3> 27 patients (18.5% male, median age 48 (IQR 31–57) underwent combined SCE and CCE to investigate altered bowel habit (n=20), abdominal pain (n=15), anaemia (n=5) and weight loss (n=5). SCE visualised the stomach for 44.5 (IQR 15.5–87.3) and small bowel for 235 (IQR 137–370.5) min with a caecal intubation rate of a 88.9%. CCE visualised the small bowel for 72 (IQR 45.5–147) and colon for 103 (IQR 60–216) min. Median colon cleanliness score was 3 (IQR 2–3) and complete examination rate was 66.7%. Pathology was detected in 74.1% of patients: it was considered relevant to the indication in 40.7% of patients. Significant diagnoses included Crohn9s disease (n=8), polyps (n=4) and NSAID colopathy (n=1). Gastric erosions, polyps and altered blood in the stomach were noted in 3 patients. Of those with Crohn9s disease, ileal disease was identified by colon CE in all cases. <h3>Conclusion</h3> Single visit whole gut remote endoscopy with combination CE is feasible using the novel protocol described. The main indication was altered bowel habit with or without pain in patients &lt;50 years of age in which the main imperative is to differentiate inflammatory bowel or coeliac disease from functional bowel disorders. CCE may suffice to provide evidence of Crohn9s disease in most cases without the need for SCE. Whole gut CE may become a first line GI diagnostic test, identifying patients for targeted conventional endoscopic biopsy and avoiding unnecessary invasive investigation in the future.
Short-term and long-term effects of lay groups on weight reduction.
Authors: A Grimsmo, G Helgesen, C Borchgrevink
Journal: BMJ (1981)

Three groups participated in a slimming programme run by lay people. The course lasted eight weeks, and the average weight loss was about 7 kg both in a small well-controlled study of 33 women and in a much larger one comprising over 10,000 people. Both studies were prospective. The long-term effect was studied in a random sample of about 1000 people. After four years 30-35% of the participants had kept the initial weight loss or were still reducing their weight, and only 15% had regained all the lost weight or more. That this result was better than usual may be because the programme operated through small groups of eight to 12 members run by the obese people themselves. The "slim-club hostesses' had all been obese and had succeeded in losing weight in the same programme. Group pressure and competition may also be important. Finally, the programme tried to change life styles, encouraging more exercise and reduced consumption of alcohol. The combination of scientific methods (behaviour therapy) and lay work may provide a clue for solving obesity and other serious health problems.
Severe chronic neutropenia: Treatment and follow‐up of patients in the Severe Chronic Neutropenia International Registry
Authors: David C. Dale, Tammy E. Cottle, Carol J. Fier, Audrey Anna Bolyard, Mary Ann Bonilla, Laurence A. Boxer, Bonnie Cham, Melvin H. Freedman, George Kannourakis, Sally E. Kinsey, Robert Davis, Debra Scarlata, Beate Schwinzer, Cornelia Zeidler, Karl Welte
Journal: American Journal of Hematology (2003)

Abstract Severe chronic neutropenia (SCN) is defined as an absolute neutrophil (ANC) of less than 0.5 × 10 9 /L, lasting for months or years. Congenital, cyclic, and idiopathic neutropenia are principal categories of SCN. Since 1994, the Severe Chronic Neutropenia International Registry (SCNIR) has collected data to monitor the clinical course, treatments, and disease outcomes for SCN patients. This report summarizes data for 853 patients, almost all treated with daily or alternate‐day recombinant human granulocyte colony‐stimulating factor (G‐CSF or Filgrastim). G‐CSF treatment increased the ANC overall from 0.34 × 10 9 /L ± 0.018 pre‐treatment to 3.70 × 10 9 /L ± 0.18 during the first year of treatment. For most patients, the responses were durable with patients remaining on the same dose of G‐CSF for many years. Long‐term hematological observations showed stable mean leukocyte and neutrophil counts and gradually increasing hemoglobin levels. Thrombocytopenia developed in 4% of patients. As of January 1, 2000, myelodysplasia (MDS) or acute myelogenous leukemia (AML) has occurred in 35 of 387 patients with congenital neutropenia with a cumulative risk of 13% after 8 years of G‐CSF treatment. This event occurred without a predictable relationship to the duration or dose of G‐CSF treatment. No patients with cyclic or idiopathic neutropenia developed MDS or AML. Other important adverse events included hepatomegaly, osteoporosis, vasculitis, glomerulonephritis, and deaths in 4 of 14 cases requiring splenectomy. Growth and development and the outcome of pregnancy appeared to be unaffected by G‐CSF treatment. These data indicate that congenital, cyclic, and idiopathic neutropenia can be effectively treated with long‐term G‐CSF. The risk of leukemia, osteoporosis, other potentially adverse events, and pregnancy outcome need to be further evaluated with continuing long‐term observations. Am. J. Hematol. 72:82–93, 2003. © 2003 Wiley‐Liss, Inc.
Recognition of oligonucleotide-encoded T cell epitopes introduced into a gene unrelated to the original antigen.
Authors: G Chimini, P Pala, J Sire, B R Jordan, J L Maryanski
Journal: The Journal of Experimental Medicine (1989)

We have previously demonstrated that H-2Kd-restricted CTL specific for HLA-CW3 or HLA-A24 can recognize synthetic peptides corresponding to residues 170-182 of the HLA molecules. Synthetic oligonucleotides encoding region 170-182 of CW3 or A24 were inserted into the influenza nucleoprotein (NP) gene. We demonstrate herein that P815 (H-2d) cells transfected with the NP-oligo recombinant genes are specifically lysed by HLA-specific Kd-restricted CTL clones. Our results imply that there must be a high degree of flexibility for the expression of T cell epitopes in different molecular contexts.
Cough and Wheezing from Beclomethasone Dipropionate Aerosol Are Absent After Triamcinolone Acetonide
Authors: CHANG S. SHIM
Journal: Annals of Internal Medicine (1987)

Study Objective: To test the hypothesis that patients with asthma who develop cough and wheezing after the use of beclomethasone aerosol would have a better tolerance for triamcinolone aerosol. Design: Randomized, double-blinded, crossover trial. Setting: Pulmonary function laboratory. Patients: Volunteer sample of 24 patients attending an asthma clinic who had developed cough, with or without wheezing, after inhaling beclomethasone aerosol. All patients completed the study. Interventions: Aerosols were used in habitual manufacturers' preparations and canisters, but both were administered in three puffs through the delivery system used for triamcinolone. The preparations differed in drug (beclomethasone dipropionate or triamcinolone acetonide), propellant (trichloromonofluoromethane and dichlorodifluoromethane, or dichlorodifluoromethane alone, respectively) and dispersant (oleic acid or dehydrated alcohol, respectively). Patients inhaled three puffs of one aerosol on one day and three of the other on the next. Measurements and Main Results: Forced expiratory volume in one second (FEV1) was measured before and after each aerosol application. The FEV1 decreased a mean of 17.7% from baseline after inhalation of beclomethasone, and 0.8% after triamcinolone (difference, 16.9%; 95% confidence limits, 12.36 to 21.34; p < 0.001). Coughs were counted after each puff. The mean number of coughs after beclomethasone aerosol inhalation was 35.8, and after triamcinolone, 0.5 (difference, 35.3; 95% confidence limits, 22.62 to 47.98, p < 0.001). Conclusions: Asthmatic patients who are unable to inhale beclomethasone aerosol due to cough or wheezing can inhale triamcinolone aerosol without difficulty. Our investigation does not determine the exact cause of the coughing and wheezing with the beclomethasone aerosol, but we suspect the dispersant as the source.
901-18 Naroparcil, a β-D Xyloside Analog, Limits Intimal Hyperplasia After Arterial Injury
Authors: Pierre Bélichard, Marianne Ziol, Ouafae Tahlil, Claude Robert, Philippe Masson, Didier Pruneau, Patrick Bruneval, P. Gabriel Steg
Journal: Journal of the American College of Cardiology (1995)
Metabolic fate of extracted glucose in normal human myocardium.
Authors: J A Wisneski, E W Gertz, R A Neese, L D Gruenke, D L Morris, J C Craig
Journal: Journal of Clinical Investigation (1985)

Glucose is an important substrate for myocardial metabolism. This study was designed to determine the effect of circulating metabolic substrates on myocardial glucose extraction and to determine the metabolic fate of glucose in normal human myocardium. Coronary sinus and arterial catheters were placed in 23 healthy male volunteers. [6-14C]Glucose was infused as a tracer in 10 subjects. [6-14C]Glucose and [U-13C]lactate were simultaneously infused in the other 13 subjects. Simultaneous blood samples were obtained for chemical analyses of glucose, lactate, and free fatty acids and for the the isotopic analyses of glucose and lactate. Glucose oxidation was assessed by measuring myocardial 14CO2 production. The amount of glucose extracted and oxidized by the myocardium was inversely correlated with the arterial level of free fatty acids (r = -0.71; P less than 0.0001). 20% (range, 0-63%) of the glucose extraction underwent immediate oxidation. Chemical lactate analysis showed a net extraction of 26.0 +/- 16.4%. However, isotopic analysis demonstrated that lactate was being released by the myocardium. In the 13 subjects receiving the dual-carbon-labeled isotopes, the lactate released was 0.09 +/- 0.04 mumol/ml and 49.5 +/- 29.5% of this lactate was from exogenous glucose. This study demonstrates that the circulating level of free fatty acids plays a major role in determining the amount of glucose extracted and oxidized by the normal human myocardium. Only 20.1 +/- 19.4% of the glucose extracted underwent oxidation, and 13.0 +/- 9.0% of the glucose extracted was metabolized to lactate and released by the myocardium. Thus, 60-70% of the glucose extracted by the normal myocardium is probably stored as glycogen in the fasting, resting state.
Treatment discontinuation with selective serotonin reuptake inhibitors compared with tricyclic antidepressants: a meta-analysis
Authors: I M Anderson, B M Tomenson
Journal: BMJ (1995)

<h3>Abstract</h3> <b>Objective</b>: To assess treatment discontinuation rates with selective serotonin reuptake inhibitors compared with tricyclic antidepressants. <b>Design</b>: Meta-analysis of 62 randomised controlled trials. <b>Subjects</b>: 6029 patients with major unipolar depression. <b>Main outcome measures</b>: Pooled risk ratios for drop out rates with respect to all cases of discontinuation and those due to side effects and treatment failure. <b>Results</b>: The total discontinuation rate was 10% lower with selective serotonin reuptake inhibitors than with tricyclic antidepressants (risk ratio 0.90; 95% confidence interval 0.84 to 0.97) and the drop out rate due to side effects was 25% lower (risk ratio 0.75; 0.66 to 0.84). There was no significant difference between drug classes in the drop out rates for treatment failure. The risk ratios for drop out did not differ significantly between individual selective serotonin reuptake inhibitors. <b>Conclusions</b>: Selective serotonin reuptake inhibitors are better tolerated than tricyclic antidepressants as measured by total numbers of drop outs. The definite advantage to selective serotonin reuptake inhibitors is explained by fewer drop outs due to side effects. The overall difference, however, is comparatively small and may not be clinically relevant. Analyses of cost effectiveness should not overestimate the advantage to selective serotonin reuptake inhibitors. <h3>Key messages</h3> Key messages In a meta-analysis of randomised, short term clinical trials selective serotonin reuptake inhibitors were associated with 10% fewer overall drop outs than tricyclic antidepressants (nine drop outs for every 10 with tricyclic agents) This difference was accounted for by a lower rate of drop out related to side effects of selective serotonin reuptake inhibitors (25% reduction; three drop outs for every four with tricyclic agents) This comparatively small difference in drop out rate is of uncertain importance clinically and when cost effectiveness is considered Further studies of the tolerability of selective serotonin reuptake inhibitors compared with that of tricyclic antidepressants are required over a longer period in the setting of clinical practice rather than clinical trials
Chromosome changes in a patient achieving complete remission in the acute phase of chronic myelogenous leukemia
Authors: Ronald Stern, Julie Sorenson, Doris H. Wurster‐Hill, Gibbons G. Cornwell, O. Ross McIntyre
Journal: American Journal of Hematology (1979)

A patient with chronic myelogenous leukemia (CML) had a Philadelphia chromosome (Ph') [t(9q+;22q-)] in all cells and trisomy C in 13% of cells (later determined to be trisomy 8) at the time of diagnosis. After 21 months of intermittent treatment with busulfan, the acute phase developed with the appearance of an additional abnormality (trisomy ? 19). During a complete remission and reconversion to the chronic phase, trisomies 8 and ? 19 DISAPPEARed, although the Ph' remained. Following a period of marked thrombocytosis, a second relapse occurred with the reappearance of both marker chromosomes.
The inhibitory activity of human interleukin-1 receptor antagonist is enhanced by type II interleukin-1 soluble receptor and hindered by type I interleukin-1 soluble receptor.
Authors: D Burger, R Chicheportiche, J G Giri, J M Dayer
Journal: Journal of Clinical Investigation (1995)

Interleukin-1 (IL-1) is a major proinflammatory cytokine produced by monocytes/macrophages. At the inflammatory site, IL-1 is a potent inducer of the production of prostaglandin E2 (PGE2) and metalloproteinases on fibroblast-like cells, thus triggering tissue damage. The biological activity of IL-1 is counterbalanced by two types of inhibitors: the IL-1 receptor antagonist (IL-1Ra) which competitively binds IL-1 receptor without inducing signal transduction; and IL-1 soluble receptors (IL-1sR) which bind IL-1 and diminish the free concentration of soluble cytokine, thus hampering its binding to the cell surface receptor. Since IL-1sR can also bind IL-1Ra, we studied the simultaneous effects of both inhibitors on the production of interstitial collagenase (C'ase) and PGE2 by human dermal fibroblasts and synovial cells stimulated by either IL-1 alpha or IL-1 beta. IL-1Ra inhibited fibroblast and synovial cell stimulation by approximately 90%, with the exception of C'ase production by synovial cells which was inhibited by approximately 55%. Type I IL-1sR (IL-1sRI) preferentially inhibited IL-1 alpha, whereas type II IL-1sR (IL-1sRII) mainly inhibited IL-1 beta. When IL-1Ra was used simultaneously with IL-1sRI, the final inhibition was lower than that of either of the inhibitors. The simultaneous presence of IL-1Ra and IL-1sRII abolished the IL-1-induced production of PGE2 and C'ase on both dermal fibroblasts and synovial cells, demonstrating that concurrently these two inhibitors are able to abolish most of the inflammatory response. To our knowledge, this is the first example of two types of inhibitors that abolish each other's effects, one of which acts at the receptor level and the other at the ligand level, thus leaving ligand activity unimpaired.