tbuckley/cabot-search huggingface dataset:
Primary Care–Based Buprenorphine Taper vs Maintenance Therapy for Prescription Opioid Dependence
Authors: David A. Fiellin, Richard S. Schottenfeld, Christopher J. Cutter, Brent A. Moore, Declan T. Barry, Patrick G. O’Connor
Journal: JAMA Internal Medicine (2014)

Prescription opioid dependence is increasing and creates a significant public health burden, but primary care physicians lack evidence-based guidelines to decide between tapering doses followed by discontinuation of buprenorphine hydrochloride and naloxone hydrochloride therapy (hereinafter referred to as buprenorphine therapy) or ongoing maintenance therapy.To determine the efficacy of buprenorphine taper vs ongoing maintenance therapy in primary care-based treatment for prescription opioid dependence.We conducted a 14-week randomized clinical trial that enrolled 113 patients with prescription opioid dependence from February 17, 2009, through February 1, 2013, in a single primary care site.Patients were randomized to buprenorphine taper (taper condition) or ongoing buprenorphine maintenance therapy (maintenance condition). The buprenorphine taper was initiated after 6 weeks of stabilization, lasted for 3 weeks, and included medications for opioid withdrawal, after which patients were offered naltrexone treatment. The maintenance group received ongoing buprenorphine therapy. All patients received physician and nurse support and drug counseling.Illicit opioid use via results of urinanalysis and patient report, treatment retention, and reinitiation of buprenorphine therapy (taper group only).During the trial, the mean percentage of urine samples negative for opioids was lower for patients in the taper group (35.2% [95% CI, 26.2%-44.2%]) compared with those in the maintenance group (53.2% [95% CI, 44.3%-62.0%]). Patients in the taper group reported more days per week of illicit opioid use than those in the maintenance group once they were no longer receiving buprenorphine (mean use, 1.27 [95% CI, 0.60-1.94] vs 0.47 [95% CI, 0.19-0.74] days). Patients in the taper group had fewer maximum consecutive weeks of opioid abstinence compared with those in the maintenance group (mean abstinence, 2.70 [95% CI, 1.72-3.75] vs 5.20 [95% CI, 4.16-6.20] weeks). Patients in the taper group were less likely to complete the trial (6 of 57 [11%] vs 37 of 56 [66%]; P < .001). Sixteen patients in the taper group reinitiated buprenorphine treatment after the taper owing to relapse.Tapering is less efficacious than ongoing maintenance treatment in patients with prescription opioid dependence who receive buprenorphine therapy in primary care.clinicaltrials.gov Identifier: NCT00555425.
Kinking of Splenic Artery Mimicking Gastric Leiomyoma
Authors: A. Kazsuba, I. Györi, I. Gál
Journal: Endoscopy (1993)

See also: Gastric Fundus Impression Caused by Splenic Vessels: Detection by Endoscopic UltrasoundEndoscopy 1991; 23(02): 85-87DOI: 10.1055/s-2007-1010620
Angiotensin-converting enzyme gene polymorphism is associated with coronary heart disease in non—insulin-dependent diabetic patients evaluated for 9 years
Authors: Xiao-Hong Huang, Vappu Rantalaiho, Ole Wirta, Amos Pasternack, Timo Koivula, Timo P. Hiltunen, Tapio Nikkari, Terho Lehtimäki
Journal: Metabolism (1998)
PI3K/AKT Mediated P53 Down-Regulation Participates in CpG DNA Inhibition of Spontaneous B Cell Apoptosis
Authors: Yongxin Zhou, Huiling Zhen, Yunqing Mei, Yongwu Wang, Jing Feng, Shuchang Xu, Xiaoying Fu
Journal: Cellular and Molecular Immunology (2009)
Management of the Infertile Couple
Authors: Robert W. Kistner
Journal: JAMA (1969)

This book is designed with a specific purpose. It provides a much needed guide, almost a manual, for the generalist who wishes to provide complete care for his infertile patient. There is a need for such a guide, if it assists in planning the investigation, outlines the specific steps to be employed in diagnosis and treatment, and indicates when the patient should be referred to a specialist. The author has clearly accomplished his purpose in a concise and factual presentation. Theoretical discussions, statistical data, and abnormal physiological processes have been omitted, but excellent illustrations of practical value are included. Chapter 1 orients the clinician in the field and defines the problem. Chapter 2 summarizes the normal reproductive physiology of the human female and chapters 3 and 4 describe the procedures advised during the initial examinations. The nature of male deficiency is thoroughly discussed by Freund (performance and interpretation of semen
Syndrome Associated with the Abuse of Analgesics
Authors: M. HENRY GAULT
Journal: Annals of Internal Medicine (1968)

Twenty-two patients with renal disease seen over a 4-year period had abused analgesics containing acetylsalicylic acid, phenacetin, caffeine, and in all but one instance codeine. The minimum duration of abuse was 3 years and the average, 12. Average total consumption was estimated to be 11 kg of ASA, 8 kg of phenacetin, 2.5 kg of caffeine, 0.4 kg of codeine, or 50,000 tablets. Papillary necrosis was demonstrated bilaterally in 15 patients and when active was often associated with hematuria and abdominal or loin pain. The 24-hr creatinine clearance was less than 50 ml/min in 18. Proteinuria was slight or absent, and an increase in urinary leukocyte excretion in the absence of infection was common. Acidosis, passage of papillae, and hypertension were important considerations in some patients. Bacterial infection of the kidney did not appear to be an important factor in the majority. Although features of renal disease may dominate the clinical picture, they are often absent until late in its course; related symptoms often occur only after many years of abuse and are frequently preceded by long-standing evidence of psychiatric disorder and headache and the more recent onset of upper gastrointestinal disease and anemia. These disorders occur in the same patient often enough in association with abuse of aspirin, phenacetin, and caffeine-type analgesics, both in this series and the literature, to warrant referring to them as a syndrome. Psychiatric abnormalities include long-standing personality disorders often associated with immaturity, dependence, emotional instability, anxiety, depression, and habituation to other drugs and alcohol; in most cases the psychiatric disorder must be considered the primary factor in the development of abuse and an essential aspect of treatment. Peptic ulceration of stomach or duodenum is a common association, and in this series resistance to treatment or bleeding led to gastrectomy in 12 patients. Anemia may be due to one or more of several causes. A history of abuse has to be sought carefully and may be denied. Demonstration of a positive ferric chloride test in urine or of sulfhemoglobin in blood provides suggestive evidence; these tests are also useful in follow-up studies. The majority of such patients can be persuaded to stop abusing this type of analgesic; hence, the complications of abuse must be considered preventable in the majority and require publicity.
Stridor of Recent Onset
Authors: Jane D. Siegel
Journal: JAMA (1975)

History  A 56-year-old woman with a heavy smoking history was admitted to the hospital for stridor of three weeks' duration. An anteroposterior chest roentgenogram was obtained (Fig 1) (below), followed by mediastinal tomography (Fig 2) (right).  Diagnosis  Tracheogenic carcinoma.  Comment  The chest roentgenogram (Fig 1) shows severe narrowing of the trachea above the carina with slight widening of the mediastinum. There is loss of lung volume on the right and a right lower infiltrate. The mediastinal tomogram (Fig 2) shows a symmetrical concentric mass that has reduced the trachea lumen to a diameter of 3 mm.  At fiberoptic bronchoscopy, a solid fusiform tumor narrowing the tracheal lumen was noted. A biopsy specimen disclosed a well-differentiated squamous cell carcinoma. Because of severe coronary artery disease, the patient was not a surgical candidate, and therefore was treated with radiotherapy and corticosteroids to reduce tracheal edema. The patient noted marked decrease in her
Insulin Sensitivity Does Not Account for Differences in Type 2 Diabetes Incidence Between San Antonio, Texas and Mexico City, Mexico
Authors: James P. Burke, Ken Williams, Steven M. Haffner, Clicerio Gonzalez Villalpando, Michael P. Stern
Journal: Diabetes Care (2002)

We would like to thank Belfiore and Iannello (1) for their interesting questions regarding our study (2). We agree that lower insulin sensitivity in the San Antonio, Texas population could have contributed to the elevated incidence in this population compared with the Mexico City, Mexico population. Drs. Belfiore and Iannello calculated their insulin sensitivity index using the mean fasting and 2-h insulin values from …
Overexpression of miR-155 causes expansion, arrest in terminal differentiation and functional activation of mouse natural killer cells
Authors: Rossana Trotta, Li Chen, Stefan Costinean, Srirama Josyula, Bethany L. Mundy-Bosse, David Ciarlariello, Charlene Mao, Edward L. Briercheck, Kathleen K. McConnell, Anjali Mishra, Lianbo Yu, Carlo M. Croce, Michael A. Caligiuri
Journal: Blood (2013)
Insights From Cerebellar Transcriptomic Analysis Into the Pathogenesis of Ataxia
Authors: Conceição Bettencourt, Mina Ryten, Paola Forabosco, Stephanie Schorge, Joshua Hersheson, John Hardy, Henry Houlden
Journal: JAMA Neurology (2014)

<h3>Importance</h3> The core clinical and neuropathological feature of the autosomal dominant spinocerebellar ataxias (SCAs) is cerebellar degeneration. Mutations in the known genes explain only 50% to 60% of SCA cases. To date, no effective treatments exist, and the knowledge of drug-treatable molecular pathways is limited. The examination of overlapping mechanisms and the interpretation of how ataxia genes interact will be important in the discovery of potential disease-modifying agents. <h3>Objectives</h3> To address the possible relationships among known SCA genes, predict their functions, identify overlapping pathways, and provide a framework for candidate gene discovery using whole-transcriptome expression data. <h3>Design, Setting, and Participants</h3> We have used a systems biology approach based on whole-transcriptome gene expression analysis. As part of the United Kingdom Brain Expression Consortium, we analyzed the expression profile of 788 brain samples obtained from 101 neuropathologically healthy individuals (10 distinct brain regions each). Weighted gene coexpression network analysis was used to cluster 24 SCA genes into gene coexpression modules in an unsupervised manner. The overrepresentation of SCA transcripts in modules identified in the cerebellum was assessed. Enrichment analysis was performed to infer the functions and molecular pathways of genes in biologically relevant modules. <h3>Main Outcomes and Measures</h3> Molecular functions and mechanisms implicating SCA genes, as well as lists of relevant coexpressed genes as potential candidates for novel SCA causative or modifier genes. <h3>Results</h3> Two cerebellar gene coexpression modules were statistically enriched in SCA transcripts (<i>P</i> = .021 for the tan module and<i>P</i> = 2.87 × 10<sup>−5</sup>for the light yellow module) and contained established granule and Purkinje cell markers, respectively. One module includes genes involved in the ubiquitin-proteasome system and contains SCA genes usually associated with a complex phenotype, while the other module encloses many genes important for calcium homeostasis and signaling and contains SCA genes associated mostly with pure ataxia. <h3>Conclusions and Relevance</h3> Using normal gene expression in the human brain, we identified significant cell types and pathways in SCA pathogenesis. The overrepresentation of genes involved in calcium homeostasis and signaling may indicate an important target for therapy in the future. Furthermore, the gene networks provide new candidate genes for ataxias or novel genes that may be critical for cerebellar function.
CD200 is a novel p53-target gene involved in apoptosis-associated immune tolerance
Authors: Michael D. Rosenblum, Edit Olasz, Jeffery E. Woodliff, Bryon D. Johnson, Marja C. Konkol, Kimberly A. Gerber, Rimas J. Orentas, Gordon Sandford, Robert L. Truitt
Journal: Blood (2003)
Association of Obstructive Sleep Apnea and Glucose Metabolism in Subjects With or Without Obesity
Authors: Nan Hee Kim, Nam H. Cho, Chang-Ho Yun, Seung Ku Lee, Dae Wui Yoon, Hyun Joo Cho, Jae Hee Ahn, Ji A. Seo, Sin Gon Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi, Chol Shin
Journal: Diabetes Care (2013)

The purpose of this study was to investigate whether the impact of obstructive sleep apnea (OSA) on glucose metabolism was different according to the presence or absence of obesity.A total of 1,344 subjects >40 years old from the Korean Genome and Epidemiology Study were included. OSA was detected by home portable sleep monitoring. Plasma glucose, HbA1c, and insulin resistance were compared according to OSA and obesity status. The associations between OSA and impaired fasting glucose (IFG), impaired glucose tolerance (IGT), IFG + IGT, and diabetes were evaluated in subjects with and without obesity after adjusting for several confounding variables. The effect of visceral obesity on this association was evaluated in 820 subjects who underwent abdominal computed tomography scanning.In subjects without obesity, fasting glucose, 2-h glucose after 75-g glucose loading, and HbA1c were higher in those with OSA than in those without after controlling for age, sex, and BMI. In addition, the presence of OSA in nonobese subjects was associated with a higher prevalence of IFG + IGT and diabetes after adjusting for several confounding variables (odds ratio 3.15 [95% CI 1.44-6.90] and 2.24 [1.43-3.50] for IFG + IGT and diabetes, respectively). Further adjustment for visceral fat area did not modify this association. In contrast, in those with obesity, none of the abnormal glucose tolerance categories were associated with OSA.The presence of OSA in nonobese individuals is significantly associated with impaired glucose metabolism, which can be responsible for future risk for diabetes and cardiovascular disease.
Th2 Cytokine Profiles Do Not Predict Antibody Responses and Respiratory Hyperresponsiveness Following Dermal Exposure To Isocyanates
Authors: M.J.K. Selgrade, E.H. Boykin, N. Haykal-Coates, M.R. Woolhiser, C. Wiescinski, D.L. Andrews, A.K. Farraj, D.L. Doerfler, S.H. Gavett
Journal: Journal of Allergy and Clinical Immunology (2007)
INTESTINAL OBSTRUCTION
Authors: G. H. Whipple, H. B. Stone, B. M. Bernheim
Journal: The Journal of Experimental Medicine (1914)

Intoxication is evident in a drained duodenal loop whether it opens externally or into the jejunum and may be associated with more or less immunity which can be demonstrated after a period of days. Intoxication with a closed duodenal loop is identical whether the loop is left empty at operation or filled with a lethal dose of loop fluid. This again emphasizes the fact that absorption of the poison is essentially from the mucous membrane rather than from the contents of the closed loop. The intoxication of a closed duodenal loop is not modified by the presence of bile, pancreatic juice, or gastric secretion. Cessation of the normal flow of intestinal fluids which bathe the mucous membrane may be essentially responsible for the perverted activity of the mucosa and secretion of a poisonous material into the blood. Animals may be slightly more resistant to closed or drained loops during the warm months, which may be explained by the increased loss of body heat in the colder months. This indicates that cases of acute intestinal intoxication with subnormal temperature may be benefited by a generous supply of artificial heat.
Visualization of a Popliteal Pseudoaneurysm by Radionuclide Imaging
Authors: P A MIRO, R A WERTZ, B D COLLIER
Journal: Clinical Nuclear Medicine (1992)

A case of popliteal pseudoaneurysm is reported in a patient with rheumatoid arthritis and a vascular graft. The lesion was identified on a radionuclide flow study. For such patients, it is often clinically difficult to differentiate between a dissecting Baker's cyst, thrombophlebitis, and pseudoaneurysms. This case illustrates that popliteal pseudoaneurysms should be considered in the differential diagnosis of painful popliteal fossa masses, particularly in patients who have had vascular grafts or prior trauma to this region.
Gas explosion caused by argon plasma coagulation of colonic angiodysplasias
Authors: D. Nürnberg, H. Pannwitz, K. Burkhardt, M. Peters
Journal: Endoscopy (2007)

Argon plasma coagulation (APC) is a well-established tool to treat lesions of the gastrointestinal mucosa, such as angiodysplasias [1].
Long-Term Survival in Patients With Resting Obstructive Hypertrophic Cardiomyopathy
Authors: Warren Ball, Joan Ivanov, Harry Rakowski, E. Douglas Wigle, Meredith Linghorne, Anthony Ralph-Edwards, William G. Williams, Leonard Schwartz, Ashley Guttman, Anna Woo
Journal: Journal of the American College of Cardiology (2011)
Allan Watson Downie
Authors: J. Hern
Journal: BMJ (2008)

After junior posts at Aberdeen Royal Infirmary and national service in the Royal Army Medical Corps as medical officer in the UK and in Germany, Allan Watson Downie returned to Aberdeen, where he worked in its new neurosurgical unit and with one of the physicians (Dr T Morgan) who had a special interest in neurology. To pursue this interest he moved to London, working at Maida Vale and Guy’s Hospitals. Faced with …
Treatment of chronic hepatitis C
Authors: G. L Davis
Journal: BMJ (2001)

Papers p 1151 

Chronic infection with the hepatitis C virus is extremely prevalent, averaging 1% to 2% of the world population. Fortunately, recognition of potential risk factors, changes in patterns of using injected drugs, and improved safety of the blood supply have led to a dramatic decline in the incidence of new hepatitis C virus infections in recent years. However, since most acutely infected patients become and remain chronically infected, the overall prevalence of chronic infection has not fallen. Chronic liver disease due to hepatitis C virus typically progresses slowly and usually does not result in major morbidity for many years. However, it is apparent that the large pool of patients with longstanding chronic hepatitis C is beginning to manifest the consequences of chronic infection and cirrhosis. In both the United Kingdom and the United States the incidence of hepatocellular carcinoma is increasing, deaths due to cirrhosis from chronic hepatitis C are on the rise, and hepatitis C is the leading indication for liver transplantation. In recent years, pharmacological treatment has had good results in patients with hepatitis C virus infection, with the virus being permanently eradicated …
Efficacy of Pneumococcal Vaccine
Authors: Abraham Verghese
Journal: JAMA (1981)

<h3>To the Editor.—</h3> At a time when infectious disease physicians are disturbed by underutilization of the pneumococcal vaccine, it is distressing to read in the editorial by David W. Fraser, MD, and Claire V. Broome, MD (1981; 245:498), that "we found evidence that the efficacy of the vaccine for highrisk groups may be very low." In making this statement the authors refer to their own work reported in the<i>New England Journal of Medicine</i>(1980;141:404-412), in which they used a mathematical formula to assess vaccine efficacy. The raw data consisted of isolates sent to the Centers for Disease Control for typing of 35 patients who received the vaccine and then had pneumococcal infection develop and 392 isolates of patients who were unvaccinated and had pneumococcal infections develop. The formula depends on a similar attack rate of nonvaccine infections in the vaccinated and unvaccinated groups. This presumption is based largely on
Respiratory Allergies Related to Automobile Air Conditioners
Authors: Prem Kumar, Robert Marier, Stephen H. Leech
Journal: New England Journal of Medicine (1984)

RESIDENTIAL air-conditioning systems may ameliorate the symptoms of both allergic rhinitis and bronchial asthma.1 , 2 The beneficial effect is attributed to the reduction of indoor pollen and spore counts.1 2 3 However, the contamination of home and office air conditioners with species of thermophilic actinomycetes may cause hypersensitivity pneumonitis.4 , 5 Other illnesses, such as legionnaires' disease, invasive aspergillosis, and systemic acinetobacter infections, have also been traced to the contamination of air conditioners and humidifier systems.6 7 8 In automobiles, the air-conditioning system modulates the temperature and humidity, removes particles of dust and pollen, and keeps out exhaust fumes by recirculating the air inside the car.9 In . . .
Drugs as instruments from a developmental child and adolescent psychiatric perspective
Authors: Tobias Banaschewski, Dorothea Blomeyer, Arlette F. Buchmann, Luise Poustka, Aribert Rothenberger, Manfred Laucht
Journal: Behavioral and Brain Sciences (2011)

Abstract Developmental, epidemiological, and neurobiological studies indicate that the adaptive and maladaptive functions, as well as immediate and long-term consequences of drug use, may vary by age. Early initiation seems to be associated with a reduced ability to use drugs purposely in a temporally stable, non-addictive manner. Prevention strategies should consider social environmental factors and aim to delay age at initiation.
Interleukin 6 Is Important for Survival After Partial Hepatectomy in Mice
Authors: Alex Blindenbacher, Xueya Wang, Igor Langer, Rocco Savino, Luigi Terracciano, Markus H. Heim
Journal: Hepatology (2003)

The response to partial hepatectomy (PH) is impaired in interleukin 6 (IL–6)–deficient mice. IL–6 is well known for its role in the induction of the acute phase (AP) response, and the impairment of this response after surgery and hepatectomy could explain the defective hepatocyte regeneration. In addition, it was proposed that IL–6 has an important role in stimulating the reentry of quiescent cells into the cell cycle within the first 2 to 4 hours after PH. To further analyze the role for IL–6, we performed two third hepatectomies in wild–type mice, in IL–6 knockout (KO) mice, and in IL–6 KO mice that were treated 30 minutes before surgery with intravenous (IV) (short acting) or subcutaneous (SC) (long acting) injections of recombinant IL–6. The high postoperative mortality of IL–6–deficient mice could be completely prevented by SC, but not by IV IL–6 treatment, showing the requirement of a sustained action of IL–6. However, there is a subset of IL–6 KO mice that survives a PH in good health even without IL–6 treatment. When we analyzed these mice, we found an intact liver regeneration and no indication of a block in cell cycle reentry. We conclude that the major role of IL–6 is the induction of an adaptive response to PH that ensures body homeostasis and survival.
The Principles and Practice of Medicine, 21st Edition. Edited by A. M. Harvey, R. J. Johns, V. A. McKusick, A. H. Owens, Jr., and R. S. Ross. 1,596 pp. + xxiii. Norwalk, Connecticut: Appleton-Century-Crofts, 1984.
Authors: Charles S. Davidson
Journal: Hepatology (1984)
β<sup>S</sup>‐gene‐cluster haplotypes in sickle cell anemia patients from two regions of Brazil
Authors: F. F. Costa, V. R. Arruda, M. G. Gonçalves, S. R. P. Miranda, M. H. Carvalho, M. F. Sonati, S. O. T. Saad, F. Gesteira, D. Fernandes, M. L. Nascimento, I. L. Queiroz
Journal: American Journal of Hematology (1994)