tbuckley/cabot-search huggingface dataset:
Augmented interleukin-1?-induced depression of locomotor activity in cholestatic rats
Authors: Mark G. Swain, Paul Beck, Kevin Rioux, Tai Le
Journal: Hepatology (1998)

“Sickness behaviors” such as lethargy, fatigue, and malaise occur commonly in patients with cholestatic liver diseases and contribute significantly to the morbidity associated with these diseases. However, the cause of these symptoms is unknown. Interleukin–1β (IL–1β) released within the brain has been implicated in the genesis of a number of “sickness behaviors,” including malaise and lethargy. Therefore, we investigated whether experimental cholestatic liver disease caused by bile duct resection (BDR) in rats is associated with enhanced central sensitivity to IL–1β-induced “sickness behaviors.” The central infusion of IL–1β at a dose that produced an insignificant decrease in locomotor activity in control rats produced a striking reduction in locomotor activity in cholestatic rats. The anorectic response to central IL–1β infusion was similar in cholestatic and noncholestatic animals and did not parallel our locomotor activity findings. Therefore, cholestatic liver injury is characterized by augmented central responsiveness to IL–1β with respect to a decrease in locomotor activity. These findings may explain, at least in part, the high incidence of symptoms such as fatigue, malaise, and lethargy that occur in cholestatic patients and may open novel future avenues for their treatment.
Macrovascular Risk and Diagnostic Criteria for Type 2 Diabetes
Authors: David R. Jesudason, Kerrie Dunstan, Darryl Leong, Gary A. Wittert
Journal: Diabetes Care (2003)

OBJECTIVE—The use of fasting plasma glucose (FPG) level ≥7.0 mmol/l leads to underdiagnosis of type 2 diabetes compared with the oral glucose tolerance test (OGTT). The OGTT is of limited use for population screening. Most of the increase in cardiovascular risk in relation to increasing blood glucose occurs before the threshold at which the diagnosis of type 2 diabetes is made. The aim of this study was to evaluate the use of HbA1c and FPG as predictors of type 2 diabetes and cardiovascular risk and, accordingly, to develop a rational approach to screening for abnormalities of glucose tolerance. RESEARCH DESIGN AND METHODS—OGTT and measurement of HbA1c and FPG levels were performed in 505 subjects screened for type 2 diabetes. Anthropomorphic measurements were obtained. A cardiovascular risk factor questionnaire was completed. RESULTS—The subjects were aged 19–88 years (mean 53.8). The incidence of type 2 diabetes was 10.4% based on the OGTT and 4% based on an FPG level ≥7.0 mmol/l. Using high-performance liquid chromatography (HPLC), HbA1c of &amp;lt;4.7 and ≥6.2% predicted with certainty the absence or presence of type 2 diabetes as defined by the OGTT. The corresponding cutoffs were &amp;lt;5.0 and ≥6.8% for HbA1c (DCA2000 HPLC device; Bayer Diagnostics, Mulgrave, Australia) and &amp;lt;4.7 and ≥6.4 mmol/l for FPG. However, 75–85% of subjects in each case had intermediate values, which were therefore nondiagnostic. Cardiovascular risk increased at least 2.2 times at an HbA1c level ≥6.2% (by HPLC), 1.8–2.2 times at an HbA1c level of 5.6–6.1% (by HPLC), 2 times at an FPG level ≥6.4 mmol/l, and 1.7–1.9 times at an FPG level of 5.6–6.3 mmol/l. CONCLUSIONS—Measurement of FPG and HbA1c levels will diagnose or exclude type 2 diabetes with certainty in a minority (15%) of people. There is a continuous relationship between FPG and HbA1c and cardiovascular risk. Accordingly, we propose that there is a rational basis for using either FPG and HbA1c for purposes of screening and assigning risk. Individuals with an HbA1c level of 5.6–6.1% and an FPG level of 5.6–6.3 mmol/l are at greatest risk for cardiovascular disease and should be targeted for further evaluation. An algorithm outlining a cost-effective approach is presented.
Hemorrhagic Pleural Effusion in Meigs' Syndrome
Authors: Jerome E. Neustadt
Journal: JAMA (1968)

<h3>To the Editor:—</h3> Meigs' syndrome is a disorder characterized by ascites and hydrothorax in association with a benign tumor of the ovary. The absolute criterion for the diagnosis of Meigs' syndrome is the spontaneous disappearance of the ascites and hydrothorax after removal of the tumor.<sup>1</sup> In 1964 Mazzlin and Stevens<sup>2</sup>collected all the cases of Meigs' syndrome reported in the literature and, adding one of their own, found a total number of 129. The syndrome is thus rare, but recognition is important since it is curable. It is the purpose of this report to call attention to the rare occurrence of a hemorrhagic effusion in Meigs' syndrome. The fluid in Meigs' syndrome is nearly always described as being a clear yellow transudate with a low specific gravity and low protein content.<sup>3</sup>There have been only nine cases reported in which the fluid was hemorrhagic.<sup>3-5</sup> <h3>Report of</h3>
FDG PET/CT Findings in Acquired Perforating Dermatosis
Authors: Akiko Shinmura, Koichiro Abe, Shingo Baba, Takuro Isoda, Yasuhiro Maruoka, Fumiko Yasukawa, Hiromaro Kiryu, Masayuki Sasaki, Masutaka Furue, Hiroshi Honda
Journal: Clinical Nuclear Medicine (2012)

Acquired perforating dermatosis (APD) is an uncommon cutaneous perforating disorder. We report a patient on hemodialysis who developed skin eruption and jaundice. He underwent FDG PET/CT under suspicion of biliary malignancies. PET/CT showed no significant abnormal uptake except of multiple FDG-avid nodules in the skin. The eruption he had was histopathologically diagnosed as APD by skin biopsy. His case suggests that APD should be considered as a differential diagnosis when multiple cutaneous FDG accumulations are found in a patient on hemodialysis. To the best of our knowledge, this is the first report showing the FDG PET/CT findings of APD.
Assessment of fitness for surgical procedures and the variability of anaesthetists' judgments.
Authors: M E Wilson, N B WIlliams, P J Baskett, J A Bennett, A M Skene
Journal: BMJ (1980)

Ten anaesthetists were asked to make judgments on fitness for elective operation on data derived from 200 patients. The extent of their agreement was measured using a kappa statistic, and clusters of anaesthetists who agreed well with each other were identified. Using an alternative technique, the "true" fitness category of each patient was estimated using a maximum likelihood method which estimated the error involved in making judgments on limited amounts of information. It was possible to compare the performance of each anaesthetist against the consensus and to measure deviation on an "optimism--pessimism" continuum. A simple questionnaire predicted fitness for operation by all 10 anaesthetists in 96% of cases.
Hypomethylated P4 Promoter Induces Expression of the <i>Insulin-Like Growth Factor-II</i> Gene in Hepatocellular Carcinoma in a Chinese Population
Authors: Shao Hui Tang, Dong Hua Yang, Wei Huang, Hong Ke Zhou, Xiao Hua Lu, Gang Ye
Journal: Clinical Cancer Research (2006)

Abstract Purpose: The expression of human insulin-like growth factor-II (IGF-II) is regulated by the activation of four promoters (P1-P4) acting in a development-dependent, tissue-specific manner. IGF-II overexpression associated with P3 and P4 activation is observed in animal and human hepatocarcinogenesis. We correlated P4 epigenetic alteration with P4 transcript activation and clinicopathologic features. Experimental Design: We analyzed P4 epigenetic alteration using methylation-specific PCR in 34 hepatocellular carcinoma (HCC) specimens, 34 matched adjacent nontumor specimens, and 8 normal adult liver specimens. The data were correlated with activation of P4 transcription by using reverse transcription-PCR. Epigenetic alteration was compared with patients' clinicopathologic features. Results: Compared with normal liver tissue, hypomethylation of P4 CpG islands was significantly more frequent in HCC (P = 0.03) and matched tissues (P = 0.047). P4 mRNA levels in HCC with unmethylated alleles were significantly higher than in HCC without unmethylated alleles (P = 0.001); P4 mRNA levels in matched nontumor tissues with unmethylated alleles were significantly higher than in matched nontumor tissues without unmethylated alleles (P = 0.005). P4 hypomethylation in HCC was associated with portal vein tumor embolus (P = 0.017) and poorer tumor differentiation (P = 0.025). Conclusions: These findings suggest that IGF-II P4 hypomethylation may be an early and frequent event and that it may contribute to P4 transcription expression activation during the transformation of a premalignant liver lesion to HCC. Furthermore, aberrant hypomethylation of P4 CpG islands not only may play an important role during hepatocarcinogenesis but might also be a useful biomarker for poor prognosis of patients with HCC.
The Full Story of Lithium
Authors: P. Bech
Journal: Psychotherapy and Psychosomatics (2006)

Editorials| August 10 2006 The Full Story of Lithium: A Tribute to Mogens Schou (1918–2005) Subject Area: Psychiatry and Psychology P. Bech P. Bech Search for other works by this author on: This Site PubMed Google Scholar Psychother Psychosom (2006) 75 (5): 265–269. https://doi.org/10.1159/000093947 Article history Published Online: August 10 2006 Content Tools Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn Email Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation P. Bech; The Full Story of Lithium: A Tribute to Mogens Schou (1918–2005). Psychother Psychosom 1 August 2006; 75 (5): 265–269. https://doi.org/10.1159/000093947 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll JournalsPsychotherapy and Psychosomatics Search Advanced Search This content is only available via PDF. © 2006 S. Karger AG, Basel2006Copyright / Drug Dosage / DisclaimerCopyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements. Article PDF first page preview Close Modal You do not currently have access to this content.
Quality improvement report: Safety and efficacy of nurse initiated thrombolysis in patients with acute myocardial infarction
Authors: A. Qasim
Journal: BMJ (2002)

Delay in starting thrombolytic treatment in patients arriving at hospital with chest pain who are diagnosed as having acute myocardial infarction.Audit of "door to needle times" for patients presenting with chest pain and an electrocardiogram on admission that confirmed acute myocardial infarction. A one year period in each of three phases of development was studied.The goal of the national service framework for coronary heart disease is that by April 2002, 75% of eligible patients should receive thrombolysis within 30 minutes of arriving at hospital. A district general hospital introduced a strategy to improve door to needle times. In phase 1 (1989-95), patients with suspected acute myocardial infarction, referred by general practitioners, were assessed in the coronary care unit; all other patients were seen first in the accident and emergency department. In phase 2 (1995-7), all patients with suspected acute myocardial infarction were transferred directly to a fast track area within the coronary care unit, where nurses assess patients and doctors started treatment. KEY MEASURES IMPROVEMENT: Median door to needle time in phase 1 of 45 minutes (range 5-300 minutes), with 38% of patients treated within 30 minutes. Median door to needle time in phase 2 of 40 minutes (range 5-180 minutes), with 47% treated within 30 minutesIn phase 3 (1997-2001), all patients with suspected acute myocardial infarction were transferred directly to the fast track area and assessed by a "coronary care thrombolysis nurse." If electrocardiography confirmed the diagnosis of acute myocardial infarction, the nurse could initiate thrombolytic therapy (subject to guidelines and exclusions determined by the consultant cardiologists).Median door to needle time in phase 3 of 15 minutes (range 5-70 minutes), with 80% of patients treated within 30 minutes. Systematic clinical review showed no cases in which a nurse initiated inappropriate thrombolysis.Thrombolysis started by nurses is safe and effective in patients with acute myocardial infarction. It may provide a way by which the national service framework's targets for door to needle times can be achieved.
Mortality control charts: Both components of POSSUM ratio require critical analysis
Authors: G. A Khoury
Journal: BMJ (2003)

EDITOR—Mean mortality of almost 10% and 30% (max 50%) is reported for elective and emergency gastro-oesophageal surgery in 29 units.1 Yet none had underperformed. A benchmark is set even though institutions were not randomised.

A multifactorial model is created by using POSSUM to fit this dataset.2 POSSUM's overpredicting tendency …
Endovascular Treatment of Mycotic Aortic Aneurysms
Authors: Karl Sörelius, Kevin Mani, Martin Björck, Petr Sedivy, Carl-Magnus Wahlgren, Peter Taylor, Rachel E. Clough, Oliver Lyons, Matt Thompson, Jack Brownrigg, Krassi Ivancev, Meryl Davis, Michael P. Jenkins, Usman Jaffer, Matt Bown, Zoran Rancic, Dieter Mayer, Jan Brunkwall, Michael Gawenda, Tilo Kölbel, Elixène Jean-Baptiste, Frans Moll, Paul Berger, Christos D. Liapis, Konstantinos G. Moulakakis, Marcus Langenskiöld, Håkan Roos, Thomas Larzon, Artai Pirouzram, Anders Wanhainen
Journal: Circulation (2014)

Background— Mycotic aortic aneurysm (MAA) is a rare and life-threatening disease. The aim of this European multicenter collaboration was to study the durability of endovascular aortic repair (EVAR) of MAA, by assessing late infection–related complications and long-term survival. Methods and Results— All EVAR treated MAAs, between 1999 and 2013 at 16 European centers, were retrospectively reviewed. One hundred twenty-three patients with 130 MAAs were identified. Mean age was 69 years (range 39–86), 87 (71%) were men, 58 (47%) had immunodeficiency, and 47 (38%) presented with rupture. Anatomic locations were ascending/arch (n=4), descending (n=34), paravisceral (n=15), infrarenal aorta (n=63), and multiple (n=7). Treatments were thoracic EVAR (n=43), fenestrated/branched EVAR (n=9), and infrarenal EVAR (n=71). Antibiotic was administered for mean 30 weeks. Mean follow-up was 35 months (range 1 week to 149 months). Six patients (5%) were converted to open repair during follow-up. Survival was 91% (95% confidence interval, 86% to 96%), 75% (67% to 83%), 55% (44% to 66%), and 41% (28% to 54%) after 1, 12, 60, and 120 months, respectively. Infection-related death occurred in 23 patients (19%), 9 after discontinuation of antibiotic treatment. A Cox regression analysis demonstrated non-Salmonella–positive culture as predictors for late infection–related death. Conclusions— Endovascular treatment of MAA is feasible and for most patients a durable treatment option. Late infections do occur, are often lethal, and warrant long-term antibiotic treatment and follow-up. Patients with non-Salmonella–positive blood cultures were more likely to die from late infection.
Timed barium oesophagram: better predictor of long term success after pneumatic dilation in achalasia than symptom assessment
Authors: M F Vaezi
Journal: Gut (2002)

Symptom relief post pneumatic dilation is traditionally used to assess treatment success in achalasia patients. Recently, we showed that symptom relief and objective oesophageal emptying are concordant in about 70% of patients, while up to 30% of achalasia patients report near complete symptom relief despite poor oesophageal emptying of barium.We now report the results of long term clinical follow up in these two groups of achalasia patients, assessing differences in symptomatic remission rates.Achalasia patients undergoing pneumatic dilation since 1995 were evaluated both symptomatically and objectively at regular intervals. Pre and post dilation symptoms were recorded. Barium column height was measured five minutes after ingesting a fixed volume of barium per patient to assess oesophageal emptying. Patients who initially reported near complete symptom relief were divided into two groups based on objective findings on barium study: (1) complete oesophageal emptying (concordant group), and (2) poor oesophageal emptying (discordant group). Patients were followed prospectively for symptom recurrence.Thirty four patients with complete symptom relief post pneumatic dilation were identified. In 22/34 (65%) patients, the degree of symptom and barium height improvements was similar (concordant group). In 10/34 (30%) patients, there was < 50% improvement in barium height (discordant group). Significantly (p<0.001) more discordant (9/10; 90%) than concordant (2/22; 9%) patients failed therapy at the one year follow up. Seventeen of 22 (77%) concordant patients were still in remission while all discordant patients had failed therapy by six years of follow up. Length of time in symptom remission (mean (SEM)) post pneumatic dilation was significantly (p=0.001) less for the discordant group (18.0 (3.6) months) compared with the concordant group (59.0 (4.8) months).(1) Poor oesophageal emptying is present in nearly 30% of achalasia patients reporting complete symptom relief post pneumatic dilation. (2) The majority (90%) of these patients will fail within one year of treatment. (3) Timed barium oesophagram is an important tool in the objective evaluation of achalasia patients post pneumatic dilation.
Why do research and which research to do?
Authors: R Smith
Journal: BMJ (1987)

People do research largely because "it turns them on, because it's there."They often cannot say more exactly why they do it, but rarely is it for financial reward or for Freud's "fame and the love of beautiful women."There are much quicker routes to such rewards.Research can be highly creative, rewarding, and exciting but also intensely frustrating.Those who commit their lives to it are varied, mercurial, brilliant, and strong and single minded, and, recognising this, the policy of many of those funding research (including the Medical Research Council'), has been to spot brilliant researchers and let them do what they want.Just this year Johnson and Johnson have given Sir James Black, the scientist who discovered , blockers and cimetidine, what Sir James calls "distortion free funding."2The company will play no part in directing the research but will have first refusal on any products that emerge.Sir James believes that big fanfares and publicity drives interfere with the process of research.Attempts by those who
Treatment of Recurrent Gliomas With Eflornithine
Authors: V. A. Levin, M. D. Prados, W. K. A. Yung, M. J. Gleason, S. Ictech, M. Malec
Journal: JNCI Journal of the National Cancer Institute (1992)

Oral eflornithine in combination with intravenous mitoguazone (methylbisguanylhydrazone) has shown activity against recurrent anaplastic gliomas. Eflornithine alone, however, has not been evaluated against recurrent gliomas.This study compared the antitumor activity of oral eflornithine with that of oral eflornithine combined with intravenous mitoguazone in the treatment of patients with recurrent or progressive glioblastoma multiforme as well as nonglioblastoma anaplastic gliomas.During the 1st year of therapy with eflornithine alone, the drug was given at a dose of 3.6 g/m2 on days 1-14, 22-35, and 43-56 every 8 hours; cycles were repeated every 63 days until progression. For the 2nd year, the drug was given on days 1-14, 29-42, and 57-70, with 84 days between cycles. For the 1st and 2nd years of eflornithine-mitoguazone therapy, eflornithine was given at 1.8 g/m2 on the same schedule. Mitoguazone was given intravenously at 200 mg/m2 on the final day of each 2-week sequence of eflornithine therapy. Response was determined by evaluating changes in the size of contrast-enhanced neuroimages.Because of two cases of lethal hepatic necrosis, the initial random allocation of patients to the eflornithine-mitoguazone arm was stopped after 23 patients had been accrued. Ninety-eight patients were entered in the eflornithine arm; 80 patients (36 glioblastoma multiforme patients and 44 anaplastic glioma patients) were assessable for response. Antitumor activity (partial response, minor response, and stable disease) was seen in 45% of the patients with anaplastic gliomas, for a median of 49 weeks, but in only 17% of patients with glioblastoma multiforme (median not attained). Twenty-one (20%) of the patients with anaplastic glioma and 33% of the patients with glioblastoma multiforme were removed from the study before completing the first 8-week course of therapy because of neurological deterioration and tumor progression by the 5th week of treatment.This study suggests that eflornithine alone is an effective palliative therapy for recurrent anaplastic gliomas. Additional studies are needed to confirm our finding.
Osteoporosis experts launch guidance to fill gaps left by NICE
Authors: S. Mayor
Journal: BMJ (2008)

A group of UK osteoporosis specialists have published national guidelines for the diagnosis and management of osteoporosis to provide evidence based recommendations on issues not dealt with by current guidance from the National Institute for Health and Clinical Excellence (NICE).

The National Osteoporosis Guideline Group has updated previous guidelines from the Royal College of Physicians after taking account of advances in the management of osteoporosis over the past few years, including new techniques for measuring bone mineral density, better methods for assessing the risk of fracture, and new treatments that reduce the risk of osteoporotic fractures. 

The resulting guidance is supported by professional and patients’ organisations in the field, including the Royal College of Physicians, the National Osteoporosis Society, and the British Society of Rheumatology. 

Juliet Compston, professor of bone medicine at the University of Cambridge School of Clinical Medicine and Addenbrooke’s Hospital, said, “Essentially we …