tbuckley/cabot-search huggingface dataset:
Video assisted thoracic surgery for treatment of pneumothorax and lung resections: systematic review of randomised clinical trials
Authors: Artyom Sedrakyan, Jan van der Meulen, James Lewsey, Tom Treasure
Journal: BMJ (2004)

To determine if video assisted thoracic surgery is associated with better clinical outcomes than thoracotomy for three common procedures: surgery for pneumothorax, minor resections, and lobectomy.Systematic review of randomised clinical trials.Medline, Embase, Cochrane database of systematic reviews, Cochrane controlled trials register. Reference lists of relevant articles and reviews.Criteria for inclusion were random allocation of patients and no concurrent use of another experimental medication or device. At least two authors performed and confirmed data abstraction and analyses. Information on quality of trials, demographics, frequency of the events, and numbers randomised were collected.12 trials randomised 670 patients. Video assisted thoracic surgery was associated with shorter length of stay (reduction ranged from 1.0 to 4.2 days) and less pain or use of pain medication than thoracotomy in the five out of seven trials in which the technique was used for pneumothorax or minor lung resection. In the treatment of pneumothorax, video assisted thoracic surgery was associated with substantially fewer recurrences than pleural drainage in two trials (from 20 to 53 events prevented per 100 treated patients). No substantial advantages were observed for video assisted thoracic surgery in lobectomies.Video assisted thoracic surgery is associated with better outcomes and seems to have a complication profile comparable with that of thoracotomy for the treatment of pneumothorax and minor resections. As for lobectomy, further studies are needed to determine how it compares with thoracotomy.
Will self referral for cancer tests result in better mortality outcomes or yet more activity among the worried well?
Authors: K. Byatt
Journal: BMJ (2015)

I heard the news about self referral for cancer tests on the radio, and my heart sank. Having read your detailed account,1 I am not reassured.

A key problem is confusing the three related, but very different, concepts: survival, disease specific mortality, and overall mortality. Conflate these with changing the paradigm from investigating relevant symptoms after initial assessment by a clinician (the acknowledged world …
Experimental Myocardial Infarction in Dogs
Authors: FRED K. NAKHJAVAN, HECTOR SHEDROVILZKY, HARRY GOLDBERG, James Hampson, Angel Cuesta
Journal: Circulation (1968)

A closed chest technique for production of myocardial infarction in dogs is described. After isolation of the left carotid artery, selective coronary cineangiography is performed. A guide wire is then inserted into the catheter and advanced into the circumflex or anterior descending branch of the left coronary artery. The catheter is temporarily removed. A specially designed, siliconized, stainless steel cylinder is then inserted over the guide wire. The catheter is reinserted and is used to push, direct, and lodge the stainless steel cylinder into the anterior descending or the circumflex artery. The dogs are heparinized before, and for 3 days subsequent to, constriction. Ventricular arrhythmias are treated with procainamide. Coronary cineangiograms and serial electrocardiograms are obtained after coronary artery constriction. This technique provides an accurate model for research in the field of myocardial infarction.
Sensitivity of computed tomography performed within six hours of onset of headache for diagnosis of subarachnoid haemorrhage: prospective cohort study
Authors: J. J. Perry, I. G. Stiell, M. L. A. Sivilotti, M. J. Bullard, M. Emond, C. Symington, J. Sutherland, A. Worster, C. Hohl, J. S. Lee, M. A. Eisenhauer, M. Mortensen, D. Mackey, M. Pauls, H. Lesiuk, G. A. Wells
Journal: BMJ (2011)

Objective To measure the sensitivity of modern third generation computed tomography in emergency patients being evaluated for possible subarachnoid haemorrhage, especially when carried out within six hours of headache onset. Design Prospective cohort study. Setting 11 tertiary care emergency departments across Canada, 2000-9. Participants Neurologically intact adults with a new acute headache peaking in intensity within one hour of onset in whom a computed tomography was ordered by the treating physician to rule out subarachnoid haemorrhage. Main outcome measures Subarachnoid haemorrhage was defined by any of subarachnoid blood on computed tomography, xanthochromia in cerebrospinal fluid, or any red blood cells in final tube of cerebrospinal fluid collected with positive results on cerebral angiography. Results Of the 3132 patients enrolled (mean age 45.1, 2571 (82.1%) with worst headache ever), 240 had subarachnoid haemorrhage (7.7%). The sensitivity of computed tomography overall for subarachnoid haemorrhage was 92.9% (95% confidence interval 89.0% to 95.5%), the specificity was 100% (99.9% to 100%), the negative predictive value was 99.4% (99.1% to 99.6%), and the positive predictive value was 100% (98.3% to 100%). For the 953 patients scanned within six hours of headache onset, all 121 patients with subarachnoid haemorrhage were identified by computed tomography, yielding a sensitivity of 100% (97.0% to 100.0%), specificity of 100% (99.5% to 100%), negative predictive value of 100% (99.5% to 100%), and positive predictive value of 100% (96.9% to 100%). Conclusion Modern third generation computed tomography is extremely sensitive in identifying subarachnoid haemorrhage when it is carried out within six hours of headache onset and interpreted by a qualified radiologist.
Bile acids and sphingosine-1-phosphate receptor 2 in hepatic lipid metabolism
Authors: Eric Kwong, Yunzhou Li, Phillip B. Hylemon, Huiping Zhou
Journal: Acta Pharmaceutica Sinica B (2015)

The liver is the central organ involved in lipid metabolism. Dyslipidemia and its related disorders, including non-alcoholic fatty liver disease (NAFLD), obesity and other metabolic diseases, are of increasing public health concern due to their increasing prevalence in the population. Besides their well-characterized functions in cholesterol homoeostasis and nutrient absorption, bile acids are also important metabolic regulators and function as signaling hormones by activating specific nuclear receptors, G-protein coupled receptors, and multiple signaling pathways. Recent studies identified a new signaling pathway by which conjugated bile acids (CBA) activate the extracellular regulated protein kinases (ERK1/2) and protein kinase B (AKT) signaling pathway via sphingosine-1-phosphate receptor 2 (S1PR2). CBA-induced activation of S1PR2 is a key regulator of sphingosine kinase 2 (SphK2) and hepatic gene expression. This review focuses on recent findings related to the role of bile acids/S1PR2-mediated signaling pathways in regulating hepatic lipid metabolism.
Estrogen Induces Lung Metastasis through a Host Compartment–Specific Response
Authors: Carole L. Banka, Caren V. Lund, Mai T.N. Nguyen, Andrew J. Pakchoian, Barbara M. Mueller, Brian P. Eliceiri
Journal: Cancer Research (2006)

Abstract Direct proliferative effects of estrogen (E2) on estrogen receptor–positive tumors are well documented; however, the potential for E2 to mediate effects selective for the host (i.e., angiogenesis, vascular permeability, or stromal effects), which influence tumor growth and/or metastasis, has received less attention. In this study, we examine the capacity for E2 to promote tumor growth and/or metastasis independent of direct effects on tumor cells. In these studies, we distinguish host versus tumor compartment components of E2 action in tumor growth and metastasis by analysis of E2-nonresponsive tumor cells implanted in ovariectomized (OVX) mice that contain s.c. implants of placebo (OVX) or E2-containing slow-release pellets (OVX + E2). We show that the D121 lung carcinoma cell line is E2-nonresponsive, and following s.c. implantation in OVX versus OVX + E2 mice, E2 action on the host compartment leads to an increase in spontaneous metastasis but not primary tumor growth or neovascularization. Similarly, experimental lung metastasis of E2-nonresponsive 4T1 mammary carcinoma cells also leads to increased tumor burden in the lungs of OVX + E2 mice. These results suggest that the E2 status of the host compartment influences late steps in tumor cell metastasis that can provide important insights into the role of E2 in the tumor versus host compartments. (Cancer Res 2006; 66(7): 3667-72)
Targeting activated T cells: successful use of anti-CD25 monoclonal antibody basiliximab in a patient with systemic sclerosis
Authors: H U Scherer, G-R Burmester, G Riemekasten
Journal: Annals of the Rheumatic Diseases (2006)

Serum levels of soluble interleukin (IL) 2 receptor strongly correlate with skin involvement, disease progression and mortality in systemic sclerosis (SSc).1,2 This finding underlines the role of activated and possibly dysregulated T cells in the pathogenesis of the disease. Specifically targeting these cells may therefore be a new therapeutic approach. Basiliximab is a chimeric monoclonal antibody directed against the α chain (CD25) of the IL2 receptor.3 It is approved for the treatment of kidney allograft rejections. Here, we describe the successful use of basiliximab in combination with cyclophosphamide in a patient with severe, rapidly progressive SSc.

In February 2004, a 43-year-old woman with a 3-year history of Scl-70-positive, diffuse SSc presented to our department. Despite prior treatment with methotrexate, prostacycline infusions, azathioprine and calcium channel blockers, the patient presented with severe Raynaud’s phenomenon, digital ulcers (fig 1A) …
Glycemic Control Is Related to the Electrophysiologic Severity of Diabetic Peripheral Sensorimotor Polyneuropathy
Authors: Ivan Tkac, Vera Bril
Journal: Diabetes Care (1998)

OBJECTIVE The aim of the present study was to examine risk factors for the electrophysiologic severity of diabetic peripheral sensorimotor polyneuropathy (DSP). RESEARCH DESIGN AND METHODS A total of 97 patients with type 1 diabetes (25 patients) or type 2 diabetes (72 patients) were included in this cross-sectional study. Nerve conduction studies (NCS) were performed on median motor and sensory nerves, peroneal motor nerve, and both sural nerves. The severity of DSP was expressed as the sum of nerve conduction velocities (SNCV) and the score of distal amplitudes (SAMP) of the above-mentioned nerves. General linear models were used to assess the relationship between overall severity of DSP, as well as the severity of lower extremity, upper extremity, motor nerve, or sensory nerve involvement and various risk factors. RESULTS GHb was significantly related to both SNCV and SAMP in univariate and multivariate regression analyses. This relationship was present in models where GHb was handled either as a continuous variable or as a categorical variable with highest significance level, with a GHb cutoff level of 9%. The difference in NCV for individual nerves in patients with good-to-moderate glycemic control (GHb ≤9%) and those with poor glycemic control (GHb ≥9%) ranged from 1.8 to 3.6 m/s. SAMP was also significantly lower in patients with poor control. SNCV was also significantly related in multivariate analysis to duration of diabetes and height, while SAMP was related to duration of diabetes, age, and male sex. CONCLUSIONS The severity of DSP expressed by electrophysiologic criteria was significantly related to glycemic control in a study including patients with type 1 or type 2 diabetes. Based on the results of the present study, it might be predicted that better diabetic control would decrease the severity of DSP
Regional heterogeneity of function in nonischemic dilated cardiomyopathy
Authors: Alistair A. Young, Socrates Dokos, Kimerly A. Powell, Bernhard Sturm, Andrew D. McCulloch, Randall C. Starling, Patrick M. McCarthy, Richard D. White
Journal: Cardiovascular Research (2001)

To quantify regional three-dimensional (3D) motion and myocardial strain using magnetic resonance (MR) tissue tagging in patients with non-ischemic dilated cardiomyopathy (DCM).MR grid tagged images were obtained in multiple short- and long-axis planes in thirteen DCM patients. Regional 3D displacements and strains were calculated with the aid of a finite element model. Five of the patients were also imaged after LV volume reduction by partial left ventriculectomy (PLV), combined with mitral and tricuspid valve repair.DCM patients showed consistent, marked regional heterogeneity. Systolic lengthening occurred in the septum in both circumferential (%S(C) -5+/-7%) and longitudinal (%S(L) -2+/-5%) shortening components (negative values indicating lengthening). In contrast, the lateral wall showed relatively normal systolic shortening (%S(C) 12+/-6% and %S(L) 6+/-5%, P<0.001 lateral vs. septal walls). A geometric estimate of regional stress was correlated with shortening on a regional basis, but could not account for the differences in shortening between regions. In the five patients imaged post-PLV, septal function recovered (%S(C) 9+/-5%,%S(L) 6+/-5%, P<0.02 pre vs. post) with normalization of wall stress, whereas lateral wall shortening was reduced (%S(C) 7+/-6%,%S(L) 3+/-3%, P<0.02 pre vs. post) around the site of surgical resection.A consistent pattern of regional heterogeneity of myocardial strain was seen in all patients. Reduced function may be related to increased wall stress, since recovery of septal function is possible after PLV. However, simple geometric stress determinants are not sufficient to explain the functional heterogeneity observed.
A NEW INSTRUMENT FOR THE CURE OF HYDROCELE.
Authors: WILLIAM T. BELFIELD
Journal: JAMA (1906)

The cure of hydrocele by injection with carbolic acid has obvious advantages over the cutting operations. Its serious defects have been (1) uncertainty of a cure, (2) unintentional injection of the acid into the scrotal tissues. Recurrence resuits from failure to destroy the serous surface, and this in turn from incomplete removal of the albuminous hydrocele fluid, an adherent layer of which protects the serous surface from the caustic effect of the acid. These defects are remedied by the following method with the instrument herewith pictured, whose distinctive feature is the window in the canula. <h3>METHOD OF USE.</h3> The distended scrotum is transfixed from above downward; after withdrawal of trocar and escape of fluid, the lower end of the canula is closed by the cap and the sac is distended with warm salt solution injected through the upper end. Removal of the cap allows the solution to escape; and this
Bile acids are physiological ligands for a nuclear receptor
Authors: J R F WALTERS
Journal: Gut (2000)

Bile acids are essential for the solubilization and transport of dietary lipids and are the major products of cholesterol catabolism. Results presented here show that bile acids are physiological ligands for the farnesoid X receptor (FXR), an orphan nuclear receptor. When bound to bile acids, FXR repressed transcription of the gene encoding cholesterol 7 alpha-hydroxylase, which is the rate-limiting enzyme in bile acid synthesis, and activated the gene encoding intestinal bile acid-binding protein, which is a candidate bile acid transporter. These results demonstrate a mechanism by which bile acids transcriptionally regulate their biosynthesis and enterohepatic transport.
Changes in extracellular pH mediate the chronotropic responses to ?-arginine
Authors: P Musialek
Journal: Cardiovascular Research (1999)

We have recently shown that exogenous nitric oxide (NO) elicits a positive chronotropic response by stimulating the hyperpolarization activated current, If. Objective: To examine whether l-arginine (l-Arg) can mimic the chronotropic effect of NO by enhancing its endogenous production. Methods: In spontaneously beating guinea pig atria we evaluated the heart rate (HR) response to increasing concentrations of l-Arg (1 μmol/l to 10 mmol/l), and compared it with that for d-Arg or l-lysine (l-Lys) (all in free base (FB) or hydrochloride (HCl) formulation). Results:l-ArgFB >100 μmol/l caused a reversible dose-dependent increase in HR (peak effect +64±7 bpm at 10 mmol/l, P<0.05, n=8). However, a similar HR response occurred with d-ArgFB (n=7) or l-LysFB (n=6). All FB formulations increased the perfusate pH (peak [pH]o=8.61±0.03). Although alkalinization can stimulate NO release from the endothelium, this is unlikely to have contributed to HR changes in our preparation, since neither NG-methyl-l-arginine, (100–500 μmol/l, which per se reduced HR by 8±1%, P<0.05, n=9) nor NO scavenging (fresh 5% red blood cells, n=9) caused a rightward shift of the concentration–response curve to l-ArgFB. Furthermore, as opposed to FB formulations, L-ArgHCl, d-ArgHCl or l-LysHCl >1 mmol/l significantly decreased HR and [pH]o (n=17). The chronotropic effects of l-ArgFB or l-ArgHCl were reproduced by changing [pH]o with NaOH (n=8) or HCl (n=7), whereas the HR increase with l-ArgFB was prevented by clamping [pH]o at 7.42±0.07 (n=10). Conclusions: In vitro, l-Arg can markedly affect HR through a pH-mediated, NO-independent mechanism. Our data show that the opposing changes in [pH]o induced by different formulations of l-Arg can importantly confound the assessment of the biological effects of this amino acid.
CENTRIFUGAL ANALYSIS OF URINE.
Authors: CHARLES W. PURDY
Journal: JAMA (1900)

The immense value of urinary analysis in its interpretations of physiologic and pathologic processes may now be said to be fully appreciated by the practical clinician. The disturbance of metabolism, the derangement of the physiologic balance, the disorder of secretion and excretion, indeed the tendency toward death or recovery are often more accurately indicated by careful scrutiny of the urine than by any other available means. The many and important improvements in our methods of analysis have done much to place this subject within the ready reach of the advanced physician. It must, however, be admitted that, notwithstanding the degree of advancement attained in expert laboratory work, there remains much to be accomplished in the way of rendering many of the processes more expeditious and ready, so that they may be made more generally available by the busy physician in practical work. Up to the present time the more rapid
The Crisis in Local Institutional Review Boards
Authors: William J. Burman, Randall R. Reves
Journal: Annals of Internal Medicine (2002)

Letters5 March 2002The Crisis in Local Institutional Review BoardsWilliam J. Burman, MD and Randall R. Reves, MDWilliam J. Burman, MDDenver Public Health; Denver, CO 80204 (Burman, Reves)Search for more papers by this author and Randall R. Reves, MDDenver Public Health; Denver, CO 80204 (Burman, Reves)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-136-5-200203050-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We are gratified that our paper generated long overdue discussion about the crisis in local IRB function. We hope that the recommendations from the National Bioethics Advisory Commission on human subjects protection and IRB function (1) will promote further discussion and bring about meaningful changes. The Commission clearly recognized the impossible demands on local IRBs in the present system, and their recommendations should improve protection of patient safety while decreasing the inefficiencies in the present system. The Herculean efforts of Dr. Siegel and colleagues to track and interpret the onslaught of adverse event reports from multicenter trials fulfill ...References1. . Report and Recommendations of the National Bioethics Advisory Commission. Volume 1: Ethical and Policy Issues in Research Involving Human Participants. Bethesda, MD: National Bioethics Advisory Commission; 2001. Google Scholar2. Davis TC, Holcombe RF, Berkel HJ, Pramanik S, Divers SG. Informed consent for clinical trials: a comparative study of standard versus simplified forms. J Natl Cancer Inst. 1998;90:668-74. [PMID: 9586663] CrossrefMedlineGoogle Scholar3. Kaplan S, Brownlee S. Dying for a cure. U.S. News and World Report. 1999; October 11. Google Scholar Author, Article, and Disclosure InformationAffiliations: Denver Public Health; Denver, CO 80204 (Burman, Reves) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoBreaking the Camel's Back: Multicenter Clinical Trials and Local Institutional Review Boards William J. Burman , Randall R. Reves , David L. Cohn , and Robert T. Schooley The Crisis in Local Institutional Review Boards Jamie Ellen Siegel , Ann Vaughn , and Elaine Baszczewski The Crisis in Local Institutional Review Boards Alan M. Sugar The Crisis in Local Institutional Review Boards Stephanie Nagy-Agren Metrics Cited ByDebate: should Australia move towards a centralized ethics committee system? . The case against 5 March 2002Volume 136, Issue 5Page: 411KeywordsAdverse eventsBioethicsClinical trialsData and safety monitoring boardsInstitutional review boardsSafety ePublished: 5 March 2002 Issue Published: 5 March 2002 CopyrightCopyright © 2002 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Don't Mix Miso With MAOIs
Authors: Roger E. Mesmer
Journal: JAMA (1987)

To the Editor.—  Monoamine oxidase inhibitors (MAOIs), particularly tranylcypromine sulfate (Parnate) and phenelzine sulfate (Nardil), have been increasingly accepted as the drugs of choice for treatment of anergic depression and some anxiety and phobic disorders. One side effect of taking these drugs is hypertensive crisis. To prevent these, medications such as tricyclic antidepressants, other MAOIs, and sympathomimetic drugs are not generally prescribed concomitantly, and patients are advised to follow a low-tyramine, low-dopamine diet.  Two soy products, miso and soy sauce, may contain enough tyramine to raise the blood pressure of a person taking MAOIs. Ingestion of soy sauce has been reported to cause hypertensive crises, and the American Dietetic Association 1 recommends using it with caution while MAOIs are being taken. Miso, a soup stock commonly used in Oriental cooking, is not usually included in low-tyramine, low-dopamine diets. It is made by fermenting soybean paste in brine for two years.
A plasma protease which is expressed during supramaximal stimulation causes in vitro subcellular redistribution of lysosomal enzymes in rat exocrine pancreas.
Authors: M Saluja, A Saluja, M M Lerch, M L Steer
Journal: Journal of Clinical Investigation (1991)

The complex events by which digestive enzyme zymogens and lysosomal hydrolases are segregated from each other and differentially transported to their respective membrane-bound intracellular organelles in the pancreas have been noted to be disturbed during the early stages of several models of experimental pancreatitis. As a result, lysosomal hydrolases such as cathepsin B are redistributed to the subcellular zymogen granule-rich fraction and lysosomal hydrolases as well as digestive enzyme zymogens are colocalized within large cytoplasmic vacuoles. The current study was designed to create an in vitro system that would reproduce this redistribution phenomenon. Our results indicate that cathepsin B redistribution occurs when rat pancreatic fragments are incubated with a supramaximally stimulating concentration of the cholecystokinin analogue caerulein along with plasma from an animal subjected to in vivo supramaximal caerulein stimulation. Neither the plasma nor a supramaximally stimulating concentration of caerulein, alone, is sufficient to induce in vitro cathepsin B redistribution. The ability of the plasma to induce in vitro cathepsin redistribution is dependent upon its content of a 10,000-30,000-D protein and is lost by exposure to protease inhibitors. In vitro cathepsin B redistribution also occurs when rat pancreatic fragments are incubated with plasma obtained from opossums with hemorrhagic necrotizing pancreatitis caused by bile/pancreatic duct ligation.