tbuckley/cabot-search huggingface dataset:
Vitamin A supplementation and BCG vaccination at birth in low birthweight neonates: two by two factorial randomised controlled trial
Authors: C. S. Benn, A. B. Fisker, B. M. Napirna, A. Roth, B. R. Diness, K. R. Lausch, H. Ravn, M. Yazdanbakhsh, A. Rodrigues, H. Whittle, P. Aaby
Journal: BMJ (2010)

<b>Objective</b> To investigate the effect of vitamin A supplementation and BCG vaccination at birth in low birthweight neonates. <b>Design</b> Randomised, placebo controlled, two by two factorial trial. <b>Setting</b> Bissau, Guinea-Bissau. <b>Participants</b> 1717 low birthweight neonates born at the national hospital. <b>Intervention</b> Neonates who weighed less than 2.5 kg were randomly assigned to 25 000 IU vitamin A or placebo, as well as to early BCG vaccine or the usual late BCG vaccine, and were followed until age 12 months. <b>Main outcome measure</b> Mortality, calculated as mortality rate ratios (MRRs), after follow-up to 12 months of age for infants who received vitamin A supplementation compared with those who received placebo. <b>Results</b> No interaction was observed between vitamin A supplementation and BCG vaccine allocation (P=0.73). Vitamin A supplementation at birth was not significantly associated with mortality: the MRR of vitamin A supplementation compared with placebo, controlled for randomisation to "early BCG" versus "no early BCG" was 1.08 (95% CI 0.79 to 1.47). Stratification by sex revealed a significant interaction between vitamin A supplementation and sex (P=0.046), the MRR of vitamin A supplementation being 0.74 (95% CI 0.45 to 1.22) in boys and 1.42 (95% CI 0.94 to 2.15) in girls. When these data were combined with data from a complementary trial among normal birthweight neonates in Guinea-Bissau, the combined estimate of the effect of neonatal vitamin A supplementation on mortality was 1.08 (95% CI 0.87 to 1.33); 0.80 (95% CI 0.58 to 1.10) in boys and 1.41 (95% CI 1.04 to 1.90) in girls (P=0.01 for interaction between neonatal vitamin A and sex). <b>Conclusions</b> The combined results of this trial and the complementary trial among normal birthweight neonates have now shown that, overall, it would not be beneficial to implement a neonatal vitamin A supplementation policy in Guinea-Bissau. Worryingly, the trials show that vitamin A supplementation at birth can be harmful in girls. Previous studies and future trials should investigate the possibility that vitamin A supplementation has sex differential effects. <b>Trial registration</b> ClinicalTrials.gov NCT00168610.
REDUCED HOSPITALIZATION FOR ST-ELEVATION MYOCARDIAL INFARCTION AFTER INTRODUCTION OF SMOKING BAN IN PUBLIC PLACES IN CANTON TICINO, SOUTHERN SWITZERLAND
Authors: Marcello Di Valentino, Stefano Muzzarelli, Aldo Rigoli, Costanzo Limoni, Giovanni Pedrazzini, Fabrizio Barazzoni, Augusto F. Gallino
Journal: Journal of the American College of Cardiology (2011)
Electropharmacology of amiodarone therapy initiation. Time courses of onset of electrophysiologic and antiarrhythmic effects.
Authors: L B Mitchell, D G Wyse, A M Gillis, H J Duff
Journal: Circulation (1989)

The time courses of onset of the electrophysiologic and antiarrhythmic effects of amiodarone were determined with serial electrophysiologic studies in 34 patients with inducible ventricular tachycardia. A standardized oral loading dosage was used for all patients (1,200 mg/day for 14 days; 800 mg/day for 7 days; and 400 mg/day thereafter). Eleven patients had the studies performed at baseline and after 2, 6, 10, and 20 weeks. Subsequently, 23 patients had studies at baseline and after 2 and 10 weeks. Changes in atrial, sinus, and atrioventricular nodal properties and in conduction intervals were maximal within 2 weeks (early effects). For example, atrioventricular nodal Wenckebach cycle length increased between baseline (369 +/- 80 msec) and 2 weeks (498 +/- 78 msec) (p less than 0.001) but did not change further after 10 weeks (500 +/- 89 msec). However, ventricular Class III effects required 10 weeks to become maximal (late effects). For example, the QT interval during atrial pacing increased between baseline (355 +/- 36 msec) and 2 weeks (406 +/- 37 msec) (p less than 0.001) and increased further after 10 weeks (436 +/- 45 msec) (p less than 0.001). Antiarrhythmic effects also followed different time courses of onset. Suppression of ventricular premature beats was maximal within 2 weeks. However, suppression of ventricular tachycardia inducibility and slowing of ventricular tachycardia rate was not maximal for 10 weeks. Correlations between serum desethylamiodarone concentrations and some late effects suggest that the mechanism of the time delay to maximal ventricular Class III effects may involve desethylamiodarone.(ABSTRACT TRUNCATED AT 250 WORDS)
Veterinary Anthelmintic Drug Is Effective Against Whipworm
Authors: M. J. Friedrich
Journal: JAMA (2014)

A deworming drug used in animals, adapted for use in humans, is effective for treating children in Tanzania with whipworm (Trichuris trichiura), report reserachers from Switzerland and Tanzania (Speich B et al. N Engl J Med. 2014;770[7]:610-616).
Glucagon-Like Peptide-1 Infusion Must Be Maintained for 24 h/day to Obtain Acceptable Glycemia in Type 2 Diabetic Patients Who Are Poorly Controlled on Sulphonylurea Treatment
Authors: Jens Larsen, Birgitte Hylleberg, Kevin Ng, Peter Damsbo
Journal: Diabetes Care (2001)

OBJECTIVE—To assess the efficacy and safety of glucagon-like peptide-1 (GLP-1) on the plasma glucose level when given as a continuous infusion for either 16 or 24 h per day to type 2 diabetic patients who were poorly controlled on sulfonylurea treatment. RESEARCH DESIGN AND METHODS—This single-center, randomized, parallel, double-blind, placebo-controlled trial was conducted in 40 hospitalized patients who were randomized to receive infusions of either placebo or GLP-1 4 or 8 ng · kg–1 · min–1 for either 16 or 24 h per day for 7 days. At predetermined intervals, 24-h profiles of glucose, glucagon, and insulin were measured. Adverse events and clinical chemistry and hematology were recorded. RESULTS—For all active treatment groups, the change in average glucose (area under the curve [AUC] for day 7 minus AUC for day 0 divided by 24 h) was statistically significantly different from placebo (P ≤ 0.001). The GLP-1 8 ng · kg–1 · min–1 dose given for 24 h was more efficacious than any of the other doses (P ≤ 0.05). Nocturnal and fasting plasma glucose levels at day 7 were greater in the 16-h groups compared with the 24-h groups (P ≤ 0.05). Insulin AUC did not show any treatment effect for any of the treatment groups when change was assessed from day 0 to day 7. However, for the 16-h groups, the pattern of the insulin profiles changed; the insulin profiles were considerably higher during the initial 3–4 h after restart of the GLP-1 infusion on day 7, although there was a tendency for insulin levels to decrease during the afternoon and evening. Glucagon AUC decreased significantly for all active treatment groups compared with placebo. GLP-1 was generally well tolerated. CONCLUSIONS—This study demonstrated that GLP-1 should be given continuously to obtain the most optimal glycemic control. Because of the short plasma half-life of native GLP-1, long-acting derivatives should be developed to make GLP-1 treatment clinically relevant.
Prevention of spontaneous hepatocarcinogenesis in farnesoid X receptor–null mice by intestinal‐specific farnesoid X receptor reactivation
Authors: Chiara Degirolamo, Salvatore Modica, Michele Vacca, Giuseppe Di Tullio, Annalisa Morgano, Andria D'Orazio, Kristina Kannisto, Paolo Parini, Antonio Moschetta
Journal: Hepatology (2014)

Farnesoid X receptor (FXR) is the master regulator of bile acid (BA) homeostasis because it controls BA synthesis, influx, efflux, and detoxification in the gut/liver axis. Deregulation of BA homeostasis has been linked to hepatocellular carcinoma (HCC), and spontaneous hepatocarcinogenesis has been observed in FXR-null mice. This dreaded liver neoplasm has been associated with both FXR gene deletion and BA-mediated metabolic abnormalities after inactivation of FXR transcriptional activity. In the present study, we addressed the hypothesis that intestinal selective FXR reactivation would be sufficient to restore the fibroblast growth factor 15 (FGF15)/cholesterol-7alpha-hydroxylase (Cyp7a1) enterohepatic axis and eventually provide protection against HCC. To this end, we generated FXR-null mice with re-expression of constitutively active FXR in enterocytes (FXR(-/-)iVP16FXR) and corresponding control mice (FXR(-/-)iVP16). In FXR-null mice, intestinal selective FXR reactivation normalized BA enterohepatic circulation along with up-regulation of intestinal FXR transcriptome and reduction of hepatic BA synthesis. At 16 months of age, intestinal FXR reactivation protected FXR-null mice from spontaneous HCC development that occurred in otherwise FXR-null mice. Activation of intestinal FXR conferred hepatoprotection by restoring hepatic homeostasis, limiting cellular proliferation through reduced cyclinD1 expression, decreasing hepatic inflammation and fibrosis (decreased signal transducer and activator of transcription 3 activation and curtailed collagen deposition).Intestinal FXR is sufficient to restore BA homeostasis through the FGF15 axis and prevent progression of liver damage to HCC even in the absence of hepatic FXR. Intestinal-selective FXR modulators could stand as potential therapeutic intervention to prevent this devastating hepatic malignancy, even if carrying a somatic FXR mutation.
The complete digestion of human milk triacylglycerol in vitro requires gastric lipase, pancreatic colipase-dependent lipase, and bile salt-stimulated lipase.
Authors: S Bernbäck, L Bläckberg, O Hernell
Journal: Journal of Clinical Investigation (1990)

Gastric lipase, pancreatic colipase-dependent lipase, and bile salt-stimulated lipase all have potential roles in digestion of human milk triacylglycerol. To reveal the function of each lipase, an in vitro study was carried out with purified lipases and cofactors, and with human milk as substrate. Conditions were chosen to resemble those of the physiologic environment in the gastrointestinal tract of breast-fed infants. Gastric lipase was unique in its ability to initiate hydrolysis of milk triacylglycerol. Activated bile salt-stimulated lipase could not on its own hydrolyze native milk fat globule triacylglycerol, whereas a limited hydrolysis by gastric lipase triggered hydrolysis by bile salt-stimulated lipase. Gastric lipase and colipase-dependent lipase, in combination, hydrolyzed about two thirds of total ester bonds, with monoacylglycerol and fatty acids being the end products. Addition of bile salt-stimulated lipase resulted in hydrolysis also of monoacylglycerol. When acting together with colipase-dependent lipase, bile salt-stimulated lipase contributed also to digestion of tri- and diacylglycerol. We conclude that digestion of human milk triacylglycerol depends on three lipases with unique, only partly overlapping, functions. Their concerted action results in complete digestion with free glycerol and fatty acids as final products.
THE RÔLE OF THE LYMPHOCYTE IN ANTIBODY FORMATION
Authors: T. N. Harris, E. Grimm, E. Mertens, W. E. Ehrich
Journal: The Journal of Experimental Medicine (1945)

Following the injection of typhoid antigen or sheep erythrocytes into the pad of the rabbit's hind foot, lymph from the efferent lymphatic of the popliteal lymph node was collected and analyzed for antibody content. On separating the lymphocytes from the lymph plasma, it was found that the antibody titer of the cell extract was substantially and consistently higher than that of the surrounding fluid. This difference was greatest at the time of greatest rate of increase of antibody titer in the whole lymph, rather than when the antibody titer of the lymph plasma was highest. These results can only be interpreted to mean that the lymphocytes either produce antibodies or take them up from the lymph plasma. Incubation in vitro of lymphocytes containing one species of antibody with lymph plasma containing another showed that antibodies pass from the cells to the supernatant lymph fluid to reach approximate equilibrium; acquisition of antibody from supernatant lymph fluid was not observed. Similar results were obtained when normal lymphocytes were allowed to incubate in vivo in their own lymph fluid to which antibodies had been added. It was again found that antibodies were not absorbed or adsorbed by lymphocytes. These results seem to indicate that lymphocytes are instrumental in the formation of antibodies.
Effect of precooling on high intensity cycling performance.
Authors: D Marsh, G Sleivert
Journal: British Journal of Sports Medicine (1999)

OBJECTIVE: To examine the effects of precooling skin and core temperature on a 70 second cycling power test performed in a warm and humid environment (29 degrees C, 80% relative humidity). METHODS: Thirteen male national and international level representative cyclists (mean (SD) age 24.1 (4.1) years; height 181.5 (6.2) cm; weight 75.5 (6.4) kg; maximal oxygen uptake (VO2peak) 66.1 (7.0) ml/kg/min) were tested in random order after either 30 minutes of precooling using cold water immersion or under control conditions (no precooling). Tests were separated by a minimum of two days. The protocol consisted of a 10 minute warm up at 60% of VO2peak followed by three minutes of stretching. This was immediately followed by the 70 second power test which was performed on a standard road bicycle equipped with 172.5 mm powermeter cranks and mounted on a stationary ergometer. RESULTS: Mean power output for the 70 second performance test after precooling was significantly (p&lt;0.005) increased by 3.3 (2.7)% from 581 (57) W to 603 (60) W. Precooling also significantly (p&lt;0.05) decreased core, mean body, and upper and lower body skin temperature; however, by the start of the performance test, lower body skin temperature was no different from control. After precooling, heart rate was also significantly lower than control throughout the warm up (p&lt;0.05). Ratings of perceived exertion were significantly higher than the control condition at the start of the warm up after precooling, but lower than the control condition by the end of the warm up (p&lt;0.05). No differences in blood lactate concentration were detected between conditions. CONCLUSIONS: Precooling improves short term cycling performance, possibly by initiating skin vasoconstriction which may increase blood availability to the working muscles. Future research is required to determine the physiological basis for the ergogenic effects of precooling on high intensity exercise.
Antihypertensive drug could be useful for eye disorder
Authors: D. Josefson
Journal: BMJ (1999)

A commonly used antihypertensive drug, the calcium blocker diltiazem, may some day be prescribed to stave off the effects of retinitis pigmentosa, a leading cause of hereditary blindness ( Nature Medicine 1999; 5:1183-7).

Retinitis pigmentosa is due to the death of retinal photoreceptors, and its onset is gradual, with night blindness and loss of peripheral vision dominating early in its course. Typically, the effects are first noted in young adulthood.

The disorder is genetically heterogeneous and defects in over 100 genes have been implicated in causing the disease.

Using a mouse model, researchers at the Universite Louis Pasteur, in Strasbourg, France, demonstrated that diltiazem is capable of rescuing photoreceptors from an untimely death. Drs Maria Frasson and Serge …
Rubella Synovitis in a One-Year-Old Patient
Authors: H. M. Hildebrandt, H. F. Maassab
Journal: New England Journal of Medicine (1966)

THE association of swollen painful joints with acute rubella infection has been noted repeatedly since it was first mentioned by Box1 in 1917 and described by Geiger2 in 1918. The present case is remarkable because it is the first case of rubella synovitis to be reported in an infant, it is the first report of isolation of rubella virus from synovial fluid, and it is the second report of isolation of any virus from joint fluid in a patient with acute synovitis.Case ReportA 14-month-old infant was admitted to St. Joseph Mercy Hospital because she refused to stand on . . .
Loss of NF1 results in activation of the Ras signaling pathway and leads to aberrant growth in haematopoietic cells
Authors: Gideon Bollag, D. Wade Clapp, Shane Shih, Felix Adler, You Yan Zhang, Patricia Thompson, Beverly J. Lange, Melvin H. Freedman, Frank McCormick, Tyler Jacks, Kevin Shannon
Journal: Nature Genetics (1996)
Gallium Nitrate for Acute Treatment of Cancer-Related Hypercalcemia
Authors: RAYMOND P. WARRELL
Journal: Annals of Internal Medicine (1988)

Study Objective: To determine whether gallium nitrate therapy is superior to maximally approved doses of calcitonin for acute control of cancer-related hypercalcemia. Design: Randomized, double-blind comparison of active treatments. Setting: Comprehensive cancer center. Patients: One hundred ninety-eight consecutive hypercalcemic events in 164 patients screened for entry. Eligibility criteria: hospitalization and intravenous hydration for at least 2 days; persistent elevated serum calcium levels of 2.99 mmol/L or greater (adjusted for serum albumin); serum creatinine levels of 221 µmol/L or less; no cytotoxic chemotherapy, radiation, or mithramycin within the preceding 7 days or during study; no concurrent use of aminoglycoside antibiotics; life expectancy greater than 4 weeks; lymphoma and parathyroid carcinoma excluded. Patients were stratified by histologic type of tumor (epidermoid or nonepidermoid). Fifty patients were randomized and treated. Interventions: Gallium nitrate 200 mg/m2 body surface area for 5 days by continuous intravenous infusion, or salmon calcitonin 8 IU/kg body weight every 6 hours for 5 days by intramuscular injection. Patients randomized to receive gallium nitrate received sham injections of saline to simulate calcitonin; patients randomized to receive calcitonin received 1000 mL 5%-dextrose solution to simulate gallium nitrate. Measurements and Main Results: All patients were evaluable. Eighteen of twenty-four patients who received gallium nitrate achieved normocalcemia compared with 8 of 26 patients who received calcitonin for an observed difference of 44% (95% confidence interval, 19% to 69%; P = 0.002). Median duration of normocalcemia before other cytotoxic or hypocalcemic therapy was 6 days for patients treated with gallium nitrate compared with 1 day for patients treated with calcitonin (P < 0.001). Median duration of normocalcemia regardless of intercurrent treatment and without adjustment for serum albumin was 11+days for patients treated with gallium nitrate and 2 days for patients treated with calcitonin (P < 0.01). Mean daily fluid intake and mean daily dose of furosemide were similar in both treatment groups. No additional benefit was seen in 9 patients randomized to receive calcitonin who incidentally received corticosteroids. Conclusions: Gallium nitrate therapy is highly effective and superior to maximally approved doses of calcitonin for acute control of cancer-related hypercalcemia.
Omeprazole Failure in a Patient with Gastroesophageal Reflux Disease
Authors: Robert Just
Journal: Annals of Internal Medicine (1994)

Letters1 December 1994Omeprazole Failure in a Patient with Gastroesophageal Reflux DiseaseRobert Just, David A. Katzka, and Donald O. CastellRobert JustThe Graduate Hospital, Philadelphia, PA 19146.Search for more papers by this author, David A. KatzkaThe Graduate Hospital, Philadelphia, PA 19146.Search for more papers by this author, and Donald O. CastellThe Graduate Hospital, Philadelphia, PA 19146.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-121-11-199412010-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:It is generally believed that omeprazole, particularly in high doses, reliably and completely suppresses gastric acid production. We describe a patient with severe gastroesophageal reflux disease who continued to have gastric acid production and markedly abnormal esophageal acid exposure while receiving omeprazole in daily doses as high as 180 mg.A 43-year-old man presented with an 11-year history of dysphagia, regurgitation, and heartburn. His physical examination was normal. A barium esophagram showed no stricture. Esophageal manometry showed poor peristalsis and a lower esophageal sphincter pressure of 23 mm Hg with complete relaxation. The patient was given omeprazole ...References1. Lagerstrom PO, Persson BA. Determination of omeprazole and metabolites in plasma and urine by liquid chromatography. J Chromatogr. 1984; 309:347-56. Google Scholar2. Sachs G, Carlsson E, Lindgberg P, Wallmar B. Gastric H, KATPase as therapeutic target. Ann Rev Pharmacol Toxicol. 1988; 28:269-84. Google Scholar3. Shamburek R, Schubert M. Control of gastric acid secretion. Gastroenterol Clin North Am. 1992; 21:527-50. Google Scholar Author, Article, and Disclosure InformationAffiliations: The Graduate Hospital, Philadelphia, PA 19146. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByGASTROESOPHAGEAL REFLUX DISEASE AND BARRETT'S ESOPHAGUSAcceptability of a paste formulation and efficacy of high dose omeprazole in healing gastric ulcers in horses maintained in race trainingMedical Treatment of Gastroesophageal Reflux Disease and Airway DiseaseClinical esophageal pH recording: A technical review for practice guideline developmentEditorial: Excluding Gastroesophageal Reflux Disease as the Cause of Chronic CoughOmeprazole for the treatment of posterior laryngitis 1 December 1994Volume 121, Issue 11Page: 899 Issue Published: 1 December 1994 CopyrightCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Donald (“Don”) Robert Smith
Authors: John Perrins
Journal: BMJ (2004)

Former consultant cardiologist Leeds (b North Shields 1932; q Newcastle 1955), died on 14 January 2004 following a ruptured aortic aneurysm.

Don Smith joined the Royal Army Medical Corps in 1958, serving in the Far East. He studied general medicine during this time and completed his MD thesis on anaemia. He returned to the UK in 1961 and joined the department of cardiology at the Hammersmith Hospital, where he became interested in valvular heart disease. In 1964 he went to Leeds as clinical lecturer in cardiology, becoming consultant cardiologist at the General Infirmary in 1967. In 1990 he was appointed the first medical director of the newly formed United Leeds Teaching Hospitals Trust. He leaves a wife, Molly, and three children.
Clinical Skin Examination Outcomes After a Video-Based Behavioral Intervention
Authors: Monika Janda, Philippa Youl, Rachel Neale, Joanne Aitken, David Whiteman, Louisa Gordon, Peter Baade
Journal: JAMA Dermatology (2014)

Importance: Older men are at risk of dying from melanoma.Objective: To assess uptake of clinical skin examination (CSE) and clinical outcomes of CSEs.Design: Behavioral randomized-controlled trial.Setting: Video-based intervention in men 50 years or older.Participants: Between June and August 2008, men 50 years or older were randomized to receive either a video-based intervention (n=469), or brochures only (n=461, response rate=37%), and were interviewed seven months later (n=870, 94% retention).Intervention: video on skin self-examination