tbuckley/cabot-search huggingface dataset:
PTH-034 The Safe And Effective Treatment Of Iron Deficiency With Iron Isomaltoside 1000 - Clinical Experience From A Uk Gastroenterology Unit
Authors: E Williams, L Craven, S Surgenor, U Bapat, C Strom, J Snook
Journal: Gut (2014)

<h3>Introduction</h3> Parenteral iron has been used increasingly over the last decade to treat specific patient groups with iron deficiency (ID) anaemia. There is, however, limited evidence of safety and efficacy in all patients with ID, particularly those with underlying malignancy or inflammation. <h3>Methods</h3> Data from all outpatients receiving iv iron isomaltoside (Monofer) for confirmed ID between 1st April and 31st December 2012 at our UK District General Hospital was analysed, regardless of underlying diagnosis or comorbidity. Patients received their infusions under the care of Gastroenterology on our Medical Investigations Unit, a 7-day nurse led unit that works extended hours and is located within the main hospital. ID was defined by ferritin &lt;24 mcg/l, transferrin saturation index (TSAT) &lt;15% or a blood film compatible with ID. Anaemia was defined as a low haemoglobin concentration (Hb) (men &lt;130 g/l, women &lt;115 g/l). Data was collected for each patients first treatment within the study period only, albeit 1 or 2 infusions. The dose of parenteral iron was at the discretion of the referring Consultant. All patients had post infusion bloods, 75 (88%) within 4 weeks. Data on the cause of ID and significant comorbidity was collected. <h3>Results</h3> 85 patients received monofer infusions for confirmed ID over the study period, with 80 of these having ID anaemia. Referrals were from a range of medical, surgical and oncological specialities. 55 patients (65%) were female and the age range was 18–92 years (median 73 years). Baseline bloods (median and interquartile range (IQR)) were Hb 90 g/l (80–99), Mean Cell Volume 81 fl (72–88), Mean Cell Haemoglobin 24.8 pg (22.2–28.0), ferritin 15mcg (9–24) and TSAT 9% (5–15). Most patients had extensive comorbidity; 29(34%) had active malignancy and 44(77%) of those without malignancy had active inflammation. The median iron dose was 14.6 mg/kg (IQR 11.2–17.5). No significant adverse reactions occurred and all patients received the full infusion. Post infusion bloods demonstrated a median increase in Hb of 23 g/l (Figure 1) with 52% having a Hb increase of &gt;20 g/l. The Hb rise was significantly higher in individuals with a lower baseline Hb; regression slope of baseline against change in Hb = -5.9 Hb, p &lt; 0.0001. <h3>Conclusion</h3> Treatment of ID anaemia with parenteral iron is safe and effective in all patients including those with cancer or active inflammation. A rapid rise in Hb within 4 weeks is seen in many patients particularly where the baseline Hb is low. <h3>Disclosure of Interest</h3> None Declared.
Hemodialysis Clearance of Theophylline
Authors: Gerhard Levy
Journal: JAMA (1977)

THE THERAPEUTIC range of plasma concentrations of the antiasthmatic drug theophylline is relatively narrow (approximately 10 to 20μg/ml). It is difficult to design safe and effective dosage regimens for this drug without monitoring plasma concentrations because of the pronounced interindividual differences in the body clearance of theophylline. These differences are magnified by the effects of disease, particularly congestive heart failure and impaired liver function, which have been found to be associated with a very low theophylline body clearance. Adverse effects of theophylline occur at high plasma concentrations of this drug. Zwillich and co-workers<sup>1</sup>described eight patients in whom grand mal seizures developed during intravenous theophylline therapy, and of whom four died. The average serum theophylline concentration in these patients was 53±4.8μg/ml. A group of patients with less severe adverse effects had an average serum theophylline concentrationof 35±1.8μg/ml, while patients without apparent adverse effects had an average serum concentration
Inhibition of canine duodenal interdigestive myoelectric complex by nutrient perfusion of jejunal and ileal Thiry-Vella loops
Authors: J C Schang, F Angel, A Lambert, F Crenner, M Aprahamian, J F Grenier
Journal: Gut (1981)

The mechanisms by which the intestinal interdigestive myoelectric complex (IDMEC), recurring at about 90 minute intervals in the fasted dog, is disrupted by feeding remain unknown. We investigated whether the IDMEC could be disrupted in the duodenum by perfusing a Thiry-Vella loop with glucose in the dog. An intestinal Thiry-Vella loop, measuring one half (80 to 160 cm) of the total length of the small bowel was constructed in four dogs from the jejunum, and in four other dogs from the ileum. Extracellular nichrome electrodes were sewn on the duodenum for recording the electrical activity of the intestine. After three weeks' recovery, electrical recordings were performed in the fasted dogs in order to observe whether the IDMEC persisted in the duodenum when the Thiry-Vella loops were perfused, at different days, for four hours with solutions made of either (1) NaCl 154 mM, (2) NaCl 308 mM, (3) glucose 300 mM, or (4) glucose 600 mM, at a rate of 8 ml/min. NaCl 308 mM and glucose 600 mM were also delivered at a rate of 4 ml/min. Glucose output from the Thiry-Vella loops was measured throughout the experiments over consecutive five minute intervals. Each experiment was performed three times in each dog. The results showed that perfusing the Thiry-Vella loops with NaCl 154 mM or NaCl 308 mM did not suppress the IDMEC in the duodenum whether the flow rate was 4 or 8 ml/min. On the contrary, perfusing the jejunal loops with glucose 300 mM disrupted the IDMEC in 54% of the experiments; perfusing glucose 600 mM disrupted the IDMEC in 83% of the experiments. In the ileal Thiry-Vella loop experiments, the IDMEC was disrupted in 33% of the cases with glucose 300 mM and in 66% of the cases with 600 mM. No significant difference was observed with glucose 300 mM delivered at a rate of 8 ml/min and glucose 600 mM delivered at a rate of 4 ml/min. Finally, the inhibitory effect of perfusing the Thiry-Vella loops with glucose increased as the amount of absorbed glucose increased. These results indicate that interruption of the IDMEC by feeding probably involves extraintestinal factors. These factors do not seem to be specific for any one part of the small intestine, but they seem to be activated by intestinal absorption.
B7-dependent T-cell costimulation in mice lacking CD28 and CTLA4
Authors: Didier A. Mandelbrot, Mariette A. Oosterwegel, Koichi Shimizu, Akira Yamada, Gordon J. Freeman, Richard N. Mitchell, Mohammed H. Sayegh, Arlene H. Sharpe
Journal: Journal of Clinical Investigation (2001)

To examine whether B7 costimulation can be mediated by a molecule on T cells that is neither CD28 nor CTLA4, we generated mice lacking both of these receptors. CD28/CTLA4–/– mice resemble CD28–/– mice in having decreased expression of T-cell activation markers in vivo and decreased T-cell proliferation in vitro, as compared with wild-type mice. Using multiple approaches, we find B7-dependent costimulation in CD28/CTLA4–/– mice. The proliferation of CD28/CTLA4–/– T cells is inhibited by CTLA4-Ig and by the use of antigen-presenting cells lacking both B7-1 and B7-2. CD28/CTLA4–/– T-cell proliferation is increased by exposure to Chinese hamster ovary cells transfected with B7-1 or B7-2. Finally, administration of CTLA4-Ig to CD28/CTLA4–/– cardiac allograft recipients significantly prolongs graft survival. These data support the existence of an additional receptor for B7 molecules that is neither CD28 nor CTLA4.
Gender, Autoantibodies, and Obesity in Newly Diagnosed Diabetic Patients Aged 40–75 Years
Authors: Marek Wroblewski, Anders Gottsater, Folke Lindgarde, Per Fernlund, Goran Sundkvist
Journal: Diabetes Care (1998)

To evaluate the frequency of autoimmune markers (islet cell antibodies (ICA] and glutamic acid decarboxylase antibodies [GADA]) and clinical features in newly diagnosed people with diabetes aged 40-75 years.Two hundred fifty-nine consecutive patients (aged 40-75 years) with newly suspected diabetes diagnosed during a 2-year period were studied. The diagnosis of newly discovered diabetes was confirmed in 203 patients. Gender, BMI, HbA1c, fasting C-peptide, ICA, and GADA were evaluated. The frequency of obesity was estimated using two different sets of criteria: 1) National Diabetes Data Group (NDDG) criteria, and 2) criteria based on a Swedish reference population.The annual incidence of diabetes was 106 per 100,000 people. The incidence of diabetes in those patients who were 40-54 years old was significantly higher in men than in women (odds ratio: 2.16; P = 0.001). ICA were detected in 16 of 203 patients (8%), whereas 17 of 203 patients (8%) were GADA+; 10 of 203 (5%) patients were positive for both ICA and GADA. Among the 203 diabetic patients, 19 (9.4%) were classified as having IDDM, giving an IDDM incidence of 10 per 100,000 people aged 40-75 years. The frequency of obesity in NIDDM was high but varied with its definition; the frequency of obesity was highest (P < 0.001) when NDDG criteria, and not Swedish reference values, were used (57 of 75 [76%] vs. 40 of 75 [53%] for women and 66 of 109 [61%] vs. 45 of 109 [41%] for men).A striking male preponderance was found among incident cases of diabetes in people aged 40-54 years. Autoimmune markers were detected in 10% of incident cases of diabetes in people aged 40-75 years. Using a conservative estimation, as many as 10 of 100,000 middle-aged and elderly subjects developed IDDM. The frequency of obesity in NIDDM was high but this was also the case in the reference population.
Reductive dehalogenation of bromoform in aqueous solution.
Authors: E A Betterton, R G Arnold, R J Kuhler, G A Santo
Journal: Environmental Health Perspectives (1995)

The hybrid semiconducter-macrocycle catalyst TiO2-cobalt phthalocyanine promotes the solar photolysis of aqueous bromoform under anaerobic conditions. The major decomposition products are dibromoethane and HBr. Bromomethane and methane were produced only after prolonged photolysis (30 hr). Acetone, derived from added 2-propanol, was the only observed oxidation product. Preliminary experiments showed that electrolytic reduction of aqueous carbon tetrachloride at a vitamin B12-modified silver electrode produced the expected lower homologues but with surprisingly high yields of methane.
Tie-2–dependent activation of RhoA and Rac1 participates in endothelial cell motility triggered by angiopoietin-1
Authors: Ilaria Cascone, Enrica Audero, Enrico Giraudo, Lucia Napione, Fabrizio Maniero, Mark R. Philips, John G. Collard, Guido Serini, Federico Bussolino
Journal: Blood (2003)
Proposals to make patients pay for medical visits in Quebec meet resistance
Authors: David Spurgeon
Journal: BMJ (2008)

A cross party task force set up to tackle the spiralling costs of Quebec’s provincial healthcare system has recommended an increase in sales tax, introduction of user fees, and greater privatisation. 

The much anticipated report from chairman, Claude Castonguay, a former Liberal health minister in 1970 when Quebec joined Canada’s federal health system, proposes among other recommendations a $C25 (£12; €17; $25) fee for each visit to a doctor and an increase of up to one percentage point in the province’s sales tax. The report has encountered considerable resistance.

Quebec’s healthcare costs …
Editors and Auditors
Authors: Drummond Rennie
Journal: JAMA (1989)

On March 3, 1987,<i>JAMA</i>received a manuscript entitled "Increased Seizure Frequency With Generic Primidone." The authors, Wyllie, Pippenger, and Rothner from The Cleveland Clinic Foundation, described the case of a 16-year-old girl who had had seizures since birth, but who, while receiving antiepileptic drugs that included Mysoline (primidone produced by Ayerst Laboratories, New York, NY) and Clonopin (now Klonopin, clonazepam produced by Hoffman—La Roche Inc, Nutley, NJ), had a seizure frequency of one or two per week. The patient had been stable with regular use of these medications for 9 years, but on two occasions, when she was switched from Mysoline to the generic form of primidone (Bolar Pharmaceutical Company, Copiague, NY), she got into difficulties. On the first occasion there was a "dramatic rise in seizure frequency" that was reversed by a switch back to Mysoline. On the second occasion "there was a precipitous drop in morning trough
Predicting persistence of wheezing: one algorithm does not fit all
Authors: P. M. Matricardi, S. Illi, T. Keil, P. Wagner, U. Wahn, S. Lau
Journal: European Respiratory Journal (2010)

Indeed, the current classification moves to the right direction by adopting a clinically meaningful way of thinking and avoiding unnecessary pathophysiological implications; PH owing to left heart disease (Group 2) and chronic thromboembolism (Group 4) are good examples.In this context, sarcoidosis, PLCH and LAM (Group 5.2) represent disorders that, according to the current evidence, are associated with PH mainly due to lung involvement and, therefore, we propose their inclusion in the third category (PH owing to lung disease and/or hypoxia) in any future classification scheme.
Endoscopic Surgery in the Rectum
Authors: G. Bueß, R. Theiß, M. Günther, F. Hutterer, H. Pichlmaier
Journal: Endoscopy (1985)

A new transanal endoscopic operative technique permits microsurgery in the rectal cavity and the placing of surgical sutures. Compared with other procedures this one is non-aggressive, and there were not postoperative complications in twelve cases. A stereoscopic optical system, a new operating rectoscope and special surgical instruments, as well as a modification to an insufflation device are necessary for the endoscopic operation.
Results of a Consecutive Series of Patients Receiving Only Antiplatelet Therapy After Optimized Stent Implantation
Authors: Remo Albiero, Patrick Hall, Akira Itoh, Simonetta Blengino, Shigeru Nakamura, Giovanni Martini, Massimo Ferraro, Antonio Colombo
Journal: Circulation (1997)

Background Previous studies have shown that stents can be inserted in coronary arteries of patients who are subsequently treated safely with antiplatelet therapy only (ticlopidine and/or aspirin) with a low incidence of stent thrombosis, provided that stent expansion is adequate and there are no other flow-limiting lesions present. However, it is unknown whether ticlopidine combined with aspirin is superior to aspirin alone in preventing stent thrombosis. Methods and Results From March 1993 through July 1995, 801 consecutive patients assigned to receive either aspirin therapy alone (ASA, 264 patients, 348 lesions) or a combination of ticlopidine and aspirin (TIC-ASA, 537 patients, 737 lesions) after a successful stent insertion, in most accomplished with intravascular ultrasound guidance, were evaluated retrospectively. At 1 month, there was no difference in the ASA group compared with the TIC-ASA group in the rate of any stent thrombosis (1.9% versus 1.9%; P =1), subacute stent thrombosis (1.9% versus 1.3%; P =.5), cumulative major adverse clinical events (1.9% versus 2.0%; P =1), and peripheral vascular complications (0.5% versus 0.2%; P =.3). Medication side effects that required termination of antiplatelet therapy occurred only in 1.9% of patients in the TIC-ASA group ( P =.04). Conclusions At 1-month clinical follow-up, stent thrombosis and other adverse clinical outcomes were not significantly different between the ASA and TIC-ASA groups. Medication side effects occurred only in patients treated with ticlopidine. These results provide further evidence of the safety of treatment with antiplatelet therapy only after optimal stent implantation and support the efficacy of aspirin alone in preventing stent thrombosis.
Effect of bran, ispaghula, and inert plastic particles on gastric emptying and small bowel transit in humans: the role of physical factors.
Authors: A McIntyre, R M Vincent, A C Perkins, R C Spiller
Journal: Gut (1997)

BACKGROUND: Coarse bran is known to accelerate transit through the whole gut and to increase stool weight. This effect is much reduced by grinding the bran, suggesting that particle size influences gut motor patterns. AIMS: To compare the effect of 15 g coarse bran with 15 g inert plastic particles and 7 g of ispaghula on the gastric emptying and small bowel transit of a rice pudding test meal. SUBJECTS: 13 healthy volunteers. METHODS: Transit of 99mTc labelled rice studied by gamma-scintigraphy measuring gastric emptying and colonic arrival over 10 hours. Small bowel transit was estimated from the difference between time to 50% gastric emptying and 50% colonic arrival. RESULTS: Bran delayed gastric emptying by 22 (SEM 8) minutes compared with control values of 88 (SEM 6) minutes p &lt; 0.05. Ispaghula and plastic particles had no significant effect. Small bowel transit was accelerated compared with control values of 322 (SEM 29) minutes, decreasing by 95 (29) minutes and 62 (22) minutes after bran and plastic particles respectively. Ispaghula again showed no significant effect. CONCLUSION: Coarse bran delays gastric emptying and accelerates small bowel transit. The marked acceleration of small bowel transit also seen with inert plastic particles may be due to increased upper gut secretions after stimulation of enteric nerves.
Predicting the Carcinogenicity of Chemicals in Humans from Rodent Bioassay Data
Authors: Gay Goodman, Richard Wilson
Journal: Environmental Health Perspectives (1991)

We conclude that there is a good qualitative (yes/no) correlation for both the rat/mouse and the rodent/human comparison.There is also a good correlation of the carcinogenic potencies between rats and mice, and the upper limits on potencies in humans are consistent with rodent potencies for those chemicals for which human exposure data are available.For the rodent/human comparison, the best estimate ofthe interspecies potency factor is lognormally distributed around 1 when the potencies in both species are measured in units of (mg/kg-day) -'.
Prevalence of occupational asthma among workers exposed to eastern white cedar.
Authors: J L Malo, A Cartier, J L'Archeveque, C Trudeau, J P Courteau, L Bherer
Journal: American Journal of Respiratory and Critical Care Medicine (1994)

We assessed the prevalence of occupational asthma among current (n = 29/31, 94%) and former (n = 13/49, 27%) employees of a sawmill in which eastern white cedar has been made into shingles during the past 3 yr. All participants answered a respiratory questionnaire, and all except one underwent spirometry and methacholine inhalation tests. All those with bronchial hyperresponsiveness (PC20 methacholine < or = 19 mg/ml) were invited to undergo specific inhalation challenges. Mean duration of exposure was 13 mo (19 workers > 12 mo). Twenty-eight workers (65%) reported a history compatible with asthma, and 25 (58%) had symptoms that were suggestive of occupational asthma. Only two subjects had significant airway obstruction (FEV1 < 80% pred) (mean value = 98% pred). Eighteen subjects (42%) had a PC20 < or = 16 mg/ml. Specific inhalation tests with plicatic acid and/or western red cedar (which contains twice as much plicatic acid as eastern white cedar), were done on 12 subjects who had a PC20 < or = 16 mg/ml when they were assessed. Three subjects were considered to have positive tests (one had an isolated immediate reaction, one had a late reaction, and one had significant changes in PC20 each time he was exposed but no changes in FEV1). Environmental monitoring showed concentrations of total dusts above 2 mg/m3 in half of the samples. The prevalence of occupational asthma in this workplace was three of 42 participants (7%) or at least three of 80 (3.8%) of all current or ex-workers. This is comparable to the prevalence of occupational asthma in subjects exposed to western red cedar.
The Role of Cyclic Adenosine Monophosphate in Adrenergic Effects on Ventricular Vulnerability to Fibrillation in the Isolated Perfused Rat Heart
Authors: W. F. Lubbe, Th. Podzuweit, P. S. Daries, L. H. Opie
Journal: Journal of Clinical Investigation (1978)

The relation between myocardial tissue cyclic AMP (cAMP) and the vulnerability to ventricular fibrillation was assessed in the isolated perfused rat heart by measurement of ventricular fibrillation threshold (VFT) and vulnerable period duration (VP). Exogenous dibutyryl cyclic AMP (DBcAMP) reduced VFT and increased VP by a concentration-related action whereas exogenous cAMP did not. Theophylline (1.0 mmol/liter) increased the tissue content of cAMP by 58% (P < 0.001) and caused a leftward shift in the concentration-response curve to DBcAMP. An effect of cAMP on VFT and VP could be shown in the presence of phosphodiesterase inhibition by theophylline. beta-1-Adrenergic receptor blockade with atenolol did not alter the concentration-response curve for VFT when DBcAMP was administered. Epinephrine (100 nmol/liter to 1 mumol/liter) also increased vulnerability to VF; this effect was accompanied by a concentration-related increase in tissue cAMP, but inconsistent changes in tissue ATP, phosphocreatine and potassium. The concentration-response curve of VFT to epinephrine was shifted leftward by theophylline and rightward by atenolol. The increases in vulnerability to fibrillation in the isolated perfused rat heart, in response to DBcAMP, theophylline or epinephrine, could be related more closely to changes of tissue cAMP than to effects on tissue high energy phosphates or potassium. The effect of epinephrine and theophylline on vulnerability to ventricular fibrillation is mediated via alterations in the intracellular level of cAMP in the isolated perfused rat heart.
Subclinical rejection impairs glomerular adaptation after renal transplantation
Authors: M. Ibernón, M. Gomá, F. Moreso, X. Fulladosa, M. Hueso, J.M. Cruzado, J. Torras, O. Bestard, J.M. Grinyó, D. Serón
Journal: Kidney International (2006)

After transplantation, glomerular volumes increases and large glomerular volume at 4 months is associated with better renal function. The aim is to characterize glomerular adaptation after the fourth month in two serial protocol biopsies and its relationship with subclinical rejection and chronic allograft nephropathy (CAN). Mean glomerular volume (Vg) was estimated according to the Weibel and Gomez method in a 4-month and 1-year serial protocol biopsies in 61 stable grafts. Glomerular enlargement (deltaVg) was calculated as the Vg difference between both biopsies. Banff schema was used to evaluate renal biopsies. Vg increased from 4.4+/-2.4 to 5.7+/-2.6 x 10(6) microm3 (P<0.001). Mean deltaVg was 1.0 x 10(6) microm3. Patients with deltaVg<1 were considered as patients with impaired glomerular enlargement (n=29). Impaired glomerular enlargement was associated with increased acute index score in the 4-month (1.83+/-1.56 vs 1.06+/-1.48; P<0.05) and 1-year protocol biopsies (1.52+/-1.59 vs 0.62+/-1.07; P<0.05). Impaired glomerular enlargement was also associated with increased progression of chronic lesions between the 4-month and 1-year biopsy in the glomerular (0.17+/-0.38 vs 0.55+/-0.63; P<0.01), tubular (0.38+/-0.56 vs 0.83+/-0.85; P<0.01), and interstitial compartment (0.41+/-0.57 vs 0.90+/-0.86; P<0.01). The proportion of sclerotic glomeruli between both biopsies increased in patients with impaired glomerular enlargement (1.5+/-3.9 to 5.3+/-10.1, P<0.05) while it did not modify in patients with glomerular enlargement (2.1+/-7.3 vs 2.6+/-4.5; P=NS). During the first year, glomeruli enlarge but this adaptation mechanism is impaired in patients with subclinical rejection. Moreover, impaired glomerular enlargement is associated with progression of CAN.