tbuckley/cabot-search huggingface dataset:
Hepatitis A hospitalizations in the United States, 2002‐2011
Authors: Melissa G. Collier, Xin Tong, Fujie Xu
Journal: Hepatology (2014)

Hepatitis A illness severity increases with age. One indicator of hepatitis A illness severity is whether persons are hospitalized. We describe changes in primary hepatitis A hospitalization rates in the United States from 2002-2011, including changes in demographics, secondary discharge diagnoses, and factors affecting hospitalization duration. We describe changes from 2002-2011 among U.S. residents hospitalized with a principal hepatitis A diagnosis and accompanying secondary diagnoses using ICD-9 codes from the National Inpatient Survey discharge data. We calculated rates of hospitalizations with hepatitis A as the principal discharge diagnosis and rates of secondary discharge diagnoses. Using multiple regression, we assessed the effect of secondary diagnoses on hospitalization length of stay for five time intervals: 2002-2003, 2004-2005, 2006-2007, 2008-2009, and 2010-2011. Rates of hospitalization for hepatitis A as a principal diagnosis decreased from 0.72/100,000 to 0.29/100,000 (P < 0.0001) and mean age of those hospitalized increased from 37.6 years to 45.5 years (P < 0.0001) during 2002-2011. The percentage of hepatitis A hospitalizations covered by Medicare increased from 12.4% to 22.7% (P < 0.0001). Secondary comorbid discharge diagnoses increased, including liver disease, hypertension, ischemic heart disease, disorders of lipid metabolism, and chronic kidney disease. No changes in length-of-stay or in-hospital deaths from hepatitis A over time were found, but persons with liver disease were hospitalized longer.Hospitalization rates for hepatitis A illness have declined significantly from 2002-2011, but the characteristics of the hospitalized population also changed. Persons hospitalized for hepatitis A in recent years are older and more likely to have liver diseases and other comorbid medical conditions. Hepatitis A disease and resulting hospitalizations could be prevented through adult vaccination.
Dual Adrenergic and Cholinergic Innervation of the Cerebral Arteries of the Rat
Authors: T. IWAYAMA, J. B. FURNESS, G. BURNSTOCK
Journal: Circulation Research (1970)

The innervation of the anterior cerebral artery of the rat was examined by electron microscopy and by the fluorescence method for localizing adrenergic nerves. Two groups of axon bundles were associated with the artery; one at the outer margin of the adventitia ( periadventitial bundles) and the other within the adventitia or at the adventitia-media border ( adventitial bundles). Periadventitial bundles consisted of nonmyelinated axons (0.1-2µ diam), some of which contained synaptic vesicles; in some bundles, myelinated axons were seen. Adventitial axons often contained many synaptic vesicles and were free of Schwann cell sheath in areas apposed to smooth muscle cells. The closest observed approach of axon to muscle cell was 800 A. No nerve fibers penetrated the medial muscle. After fixation with glutaraldehyde plus osmium, large (1000 A) granular and small (500 A) agranular vesicles were seen within many axon profiles. Small granular vesicles were rare. After permanganate fixation, terminal axons contained (besides large granular vesicles) either predominantly small granular vesicles or exclusively small agranular vesicles. Two days after sympathetic denervation, no axons containing small granular vesicles and no fluorescent fibers were seen. Adrenergic fibers were readily identified after injection of rats with 6-hydroxydopamine; small vesicles of adrenergic axons contained highly opaque granular cores, even in osmium-fixed material. Axons containing small agranular vesicles after 6-hydroxydopamine were considered cholinergic. The density of granulation of the large vesicles of adrenergic, but not cholinergic, axons was considerably enhanced following 6-hydroxydopamine. Both adrenergic and cholinergic axons come into close relationship with smooth muscle cells.
Corrigendum to “The biology of Nociceptin/Orphanin FQ (N/OFQ) related to obesity, stress, anxiety, mood, and drug dependence” [Pharmacology &amp; Therapeutics 141 (2014) 283–299]
Authors: Jeffrey M. Witkin, Michael A. Statnick, Linda M. Rorick-Kehn, John E. Pintar, Michael Ansonoff, Yanyun Chen, R. Craig Tucker, Roberto Ciccocioppo
Journal: Pharmacology & Therapeutics (2014)
Tricuspid Valve Replacement in Rheumatic Heart Disease
Authors: M. V. Braimbridge, C. L. Sarin, E. Yalav, A. J. Clement, D. Mendel
Journal: BMJ (1970)

The diagnosis of tricuspid valve disease is often difficult; the best treatment is not yet established. Twenty patients had tricuspid valve replacements at St. Thomas9s Hospital as part of multiple valve replacement procedures. The hospital mortality was 25%, most deaths being due to a low cardiac output causing hepatorenal failure. Preoperative cardiac cachexia had a fatal outcome in all cases. Except in two instances, surviving patients returned to a satisfactory level of activity.
LEGAL ASPECT OF THE FEDERAL PROTECTION OF THE PUBLIC HEALTH
Authors: W. C. RUCKER
Journal: JAMA (1913)

The public health policy of the United States has been one of gradual growth and change. In the first stage the general government assumed no authority whatsoever, other than to assist on occasions of emergency in the execution of the health laws of the state. In 1794, the Third Congress authorized the President to alter the place for holding the session of Congress if in his judgment there existed a prevalence of contagious sickness which would be hazardous to the lives or health of the members of Congress, and in 1796, he was authorized to direct the revenue officers and others to aid in the execution of quarantine and state health laws. This law was repealed in 1799. It was later reenacted. The act of Feb. 25, 1799, may be considered as the first public health law of the United States, and was the beginning of the public health work
Potential Therapeutic Levels of Glucagon-Like Peptide I Achieved in Humans by a Buccal Tablet
Authors: Mark K Gutniak, Hillevi Larsson, Sonia J Heiber, Olof T Juneskans, Jens J Holst, Bo Ahrén
Journal: Diabetes Care (1996)

OBJECTIVE Glucagon-like peptide I(7–36) (GLP-I) amide, an endogenous incretin, has been identified as a potential adjunct to the treatment of NIDDM and has been studied following intravenous and subcutaneous injection. A mucoadhesive buccal GLP-I tablet containing 119 nmol has been developed to provide transmucosal absorption as a possible alternative to injection treatment. RESEARCH DESIGN AND METHODS Eight healthy volunteers received a single tablet under fasting conditions in this randomized double-blind placebo-controlled study. A total GLP-I immunoreactivity was measured using COOH-terminal radioimmunoassay (RIA) (total peptide activity) and NH2-terminal RIA (active, nondegraded peptide). RESULTS The mean (± SE) peak GLP-I concentration was 117 ± 19 pmol/l and occurred 30 ± 4 min after application. The mean placebo-adjusted area under curve was 8,145 ± 873 pmol · min−1 · l−1, consistent with a relative bioavailability of 7% versus intravenous injection and 47% versus subcutaneous injection. The levels of active peptide increased in parallel with total GLP-I. Half-life of peptide activity after buccal administration was 27 and 24 min measured with COOH-terminal and NH2-terminal RIA, respectively. Placebo adjusted insulin concentrations increased to a peak of 252 ± 57 pmol/l, glucose decreased 1.4 ± 0.2 mmo/l, and glucagon decreased 17 ± 3 ng/l, consistent with the increase in plasma GLP-I concentrations. CONCLUSIONS Therapeutic plasma levels of GLP-I in humans were achieved after a single buccal tablet. No increased degradation of GLP-I was found in the buccal mucosa compared to subcutaneous tissue. This alternative treatment form may be feasible in in the future for NIDDM.
Combined percutaneous aortic valvuloplasty and transluminal coronary angioplasty in adult patients with calcific aortic stenosis and coronary artery disease.
Authors: R G McKay, R D Safian, A D Berman, D J Diver, J S Weinstein, R M Wyman, M J Cunningham, L L McKay, D S Baim, W Grossman
Journal: Circulation (1987)

Of 120 consecutive balloon aortic valvuloplasty procedures for critical aortic stenosis, valvuloplasty was performed in combination with coronary angioplasty in nine patients (average age 76 years). All nine patients were symptomatic with angina and congestive heart failure before combined procedures. Aortic valvuloplasty was performed with 20 to 23 mm balloon catheter advanced retrogradely from the femoral artery and resulted in an improvement in peak aortic valve gradient (60 +/- 19 to 33 +/- 13 mm Hg; p less than or equal to .01) and calculated aortic valve area (0.7 +/- 0.1 to 1.1 +/- 0.3 cm2; p less than or equal to .01). Single-vessel coronary angioplasty was performed via the femoral approach, with 2.0 to 3.5 mm balloon catheters, and resulted in a mean reduction of a critical coronary stenosis in each patient from 91 +/- 4% to 29 +/- 8%. The site of coronary angioplasty was the left anterior descending artery in three patients, the circumflex artery in three patients, the right coronary artery in two patients, and a bypass graft to the right coronary artery in one patient. Combined procedures were performed with a mean arterial time of 108 min. Complications included groin hematomas (n = 2), transient left bundle branch block (n = 1), and transient atrial fibrillation (n = 1). No patient experienced prolonged chest pain, myocardial infarction, major increase in aortic insufficiency, or embolic phenomena. Eight of the nine patients treated with combined procedures noted significant improvement in symptoms of angina and congestive heart failure and were discharged.(ABSTRACT TRUNCATED AT 250 WORDS)
Efficacy of a small single dose of oral dexamethasone for outpatient croup: a double blind placebo controlled clinical trial
Authors: G C Geelhoed, J Turner, W B G Macdonald
Journal: BMJ (1996)

<h3>Abstract</h3> <b>Objective</b>: To assess the efficacy of a single dose of oral dexamethasone 0.15 mg/kg in children with mild croup not admitted to hospital. <b>Design</b>: Double blind, randomised, placebo controlled clinical trial. <b>Setting</b>: The emergency department of a tertiary paediatric hospital. <b>Subjects</b>: 100 children aged 4-122 months presenting with mild croup. <b>Intervention</b>: A single oral dose of dexamethasone 0.15 mg/kg or placebo. <b>Main outcome measure</b>: Return to medical care with ongoing croup. <b>Results</b>: Baseline characteristics of the two treatment groups were similar. Eight children (all from the placebo group) returned to medical care with ongoing croup, one being admitted. There was no reported difference in duration of croup symptoms, duration of viral symptoms, or rate of return to medical care for other reasons. <b>Conclusion</b>: Oral dexamethasone in a dose of 0.15 mg/kg is effective in reducing return to medical care with ongoing croup in children with mild croup. <h3>Key messages</h3> The benefits of steroids for children admitted to hospital are now well estab- lished Most children with croup may be sent home, though up to one fifth may return with croup A small single dose of oral dexamethasone (0.15 mg/kg) dramatically reduces the chance of reattending All children presenting with croup should be considered for steroids
Targeting the Hepatocyte Growth Factor–cMET Axis in Cancer Therapy
Authors: George R. Blumenschein, Gordon B. Mills, Ana M. Gonzalez-Angulo
Journal: Journal of Clinical Oncology (2012)

The hepatocyte growth factor (HGF) and its receptor, the transmembrane tyrosine kinase cMET, promote cell proliferation, survival, motility, and invasion as well as morphogenic changes that stimulate tissue repair and regeneration in normal cells but can be co-opted during tumor growth. MET overexpression, with or without gene amplification, has been reported in a variety of human cancers, including breast, lung, and GI malignancies. Furthermore, high levels of HGF and/or cMET correlate with poor prognosis in several tumor types, including breast, ovarian, cervical, gastric, head and neck, and non-small-cell lung cancers. Gene amplification and protein overexpression of cMET drive resistance to epidermal growth factor receptor family inhibitors, both in preclinical models and in patients. It is increasingly apparent that the HGF-cMET axis signaling network is complex, and rational combinatorial therapy is needed for optimal clinical efficacy. Better understanding of HGF-cMET axis signaling and the mechanism of action of HGF-cMET inhibitors, along with the identification of biomarkers of response and resistance, will lead to more effective targeting of this pathway for cancer therapy.
Frequency of Papillary Dysfunction Among Cholecystectomized Patients
Authors: Simon Bar-Meir, Zamir Halpern, Eithan Bardan, Tuvia Gilat
Journal: Hepatology (1984)

Four hundred and fifty-four consecutive patients who had had their gallbladder removed were interviewed to determine the presence of upper abdominal pain, increased serum alkaline phosphatase and/or serum amylase activity. Patients with unexplained upper abdominal pain and/or enzyme abnormalities were offered endoscopic retrograde cholangiopancreatography (ERCP) and manometric evaluations. Dysfunction of the sphincter of Oddi diagnosed by ERCP manometry may account for the abdominal pain seen in 14% of the patients with postcholecystectomy syndrome. It may rarely be the cause of an elevated serum alkaline phosphatase and/or amylase when abdominal pain is not present. Papillary dysfunction is seen in less than 1% of the patients who have had their gallbladders removed. ERCP manometry is recommended in cholecystectomized patients with unexplained abdominal pain suggesting pancreaticobiliary origin.
PTH-141 Wireless Capsule Endoscopy – Diagnostic Yield And Clinical Utility Varies Widely According To Indication
Authors: MR Smith, B Drinkwater, R Mahmood, P Nicolson, S Ishaq, SC Cooper
Journal: Gut (2014)

<h3>Introduction</h3> Wireless capsule endoscopy (WCE) is a well established technique for imaging the small bowel, with an increasing clinical uptake and range of indications. We aimed to evaluate the utility of WCE, comparing the diagnostic yield of procedures by indication. <h3>Methods</h3> We performed a retrospective analysis of all WCE procedures performed at our centre, January 2007 to March 2013. <h3>Results</h3> A total of 293 procedures were performed in 279 patients, male 47%. Median age at time of procedure was 59 (IQR 45–71). The indications were: iron deficiency anaemia (IDA)/occult GI bleeding 154 (53%), known Crohn’s disease requiring assessment 58 (20%), abdominal pain (+/- other symptoms) 33 (11%), overt GI bleeding 20 (7%), isolated diarrhoea 10 (3%), coeliac disease 6 (2%), isolated weight loss 4 (1%), other 8 (3%). Of those undergoing WCE for symptoms (47; 16%), Crohn’s disease was excluded (an aim of performing the study) in 34 (72%). The median gastric transit time was 27 min (IQR 14–55), small bowel transit time 243 min (IQR 181–300). Unplanned endoscopy for failure of capsule progression was required in 8 cases (3%). 5 procedures (2%) failed to image the small bowel (failed to leave stomach (3), battery failure (1), poor views (1)). A prokinetic was used in 9% (n = 27) of procedures. Overall the diagnostic yield was 50%. Separating by indication, the diagnostic yield was highest for overt GI bleeding, 70% overall (n = 14), identifying both 9/20 small bowel causes and 5/20 in colon/upper GI tract. Yield for Crohn’s disease assessment was 63%, IDA/occult GI bleeding 46%, abdominal pain (+/- other GI symptoms) 47%. The diagnostic yield of WCE for abdominal pain in the absence of other symptoms or abnormal radiology/ileoscopy was only 14%. 23 out of 27 patients evaluated for symptoms (in the absence of anaemia/known Crohn’s) were discharged requiring no further investigation following a negative result. <h3>Conclusion</h3> Wireless capsule endoscopy has a good diagnostic yield, especially for evaluating GI blood loss (overt or occult) and assessing small bowel Crohn’s disease. Among highly symptomatic patients, WCE can facilitate completion of investigatory pathways and enable discharge to primary care. The utility of WCE in investigating isolated abdominal pain appears limited. <h3>Disclosure of Interest</h3> None Declared.
Benzodiazepines: Dependence and Withdrawal
Authors: Frank J. Ayd
Journal: JAMA (1979)

In the past two decades, billions of benzodiazepine prescriptions have been written for millions of patients who have taken these substances intermittently or continuously. Extensive use has caused health authorities and government agencies to become concerned about unknown hazards of protracted benzodiazepine use, possible dependence and tolerance, and the potential incidence of withdrawal reactions. The news media have bruited charges of overuse, misuse, and abuse, of birth defects, and of death attributable to these drugs. For the most part, however, the case against benzodiazepines remains weak, and their efficacy and safety have been demonstrated. Critics attribute the widespread use of benzodiazepines to overprescribing by irresponsible physicians—a charge refuted by a recent National Institute of Mental Health survey of psychotropic drug use by 2,500 randomly selected American adults.<sup>1</sup>This survey disclosed that only 30% of highly distressed persons had taken any psychotropic drugs during the year. Even if physicians are
Heparanase Induces Vascular Endothelial Growth Factor Expression: Correlation with p38 Phosphorylation Levels and Src Activation
Authors: Anna Zetser, Yulia Bashenko, Evgeny Edovitsky, Flonia Levy-Adam, Israel Vlodavsky, Neta Ilan
Journal: Cancer Research (2006)

Abstract Heparanase is an endo-β-d-glucuronidase involved in cleavage of heparan sulfate moieties and hence participates in extracellular matrix (ECM) degradation and remodeling. Traditionally, heparanase activity was correlated with the metastatic potential of a variety of tumor-derived cell types. Cloning of the heparanase gene indicated that heparanase expression is up-regulated in a variety of primary human tumors. In some cases, heparanase up-regulation correlated with increased tumor vascularity, an angiogenic feature that could be recapitulated in a number of in vitro and in vivo models. The mechanism by which heparanase enhances angiogenic responses is not entirely clear but is thought to be mediated primarily by release of ECM-resident angiogenic growth factors such as basic fibroblast growth factor and vascular endothelial growth factor (VEGF). Here, we examined the possibility that heparanase directly participates in VEGF gene regulation. We provide evidence that heparanase overexpression in human embryonic kidney 293, MDA-MB-435 human breast carcinoma, and rat C6 glioma cells resulted in a 3- to 6-fold increase in VEGF protein and mRNA levels, which correlated with elevation of p38 phosphorylation. Moreover, heparanase down-regulation in B16 mouse melanoma cells by a specific siRNA vector was accompanied by a decrease in VEGF and p38 phosphorylation levels, suggesting that VEGF gene expression is regulated by endogenous heparanase. Interestingly, a specific p38 inhibitor did not attenuate VEGF up-regulation by heparanase whereas Src inhibitors completely abrogated this effect. These results indicate, for the first time, that heparanase is actively involved in the regulation of VEGF gene expression, mediated by activation of Src family members. (Cancer Res 2006; 66(3): 1455-63)
Insulin Receptor Substrate-1 Suppresses Transforming Growth Factor-β1–Mediated Epithelial-Mesenchymal Transition
Authors: Jian Shi, Dong-Mei Wang, Chun-Mei Wang, Ying Hu, Ai-Hua Liu, Yong-Lian Zhang, Bing Sun, Jian-Guo Song
Journal: Cancer Research (2009)

We investigated the regulatory effect of insulin receptor substrate-1 (IRS-1) on transforming growth factor-beta1 (TGF-beta1)-induced epithelial-mesenchymal transition (EMT). TGF-beta1-induced EMT and cell migration in A549 cells are associated with a decrease in IRS-1 tyrosine phosphorylation and protein levels. Tissue microarray analysis of human lung carcinoma shows a correlation between IRS-1 protein levels and E-cadherin protein levels. High IRS-1 levels coexist with high E-cadherin levels, whereas low IRS-1 levels coexist with low E-cadherin levels, implying a possibility that IRS-1 protein levels may be linked with EMT. Surprisingly, overexpression of IRS-1 in A549 cells completely blocked TGF-beta1-induced EMT and cell migration, inhibited TGF-beta1-mediated expression of snail and slug genes, and abolished TGF-beta1-mediated repression of E-cadherin promoter activity. In contrast, IRS-1 knockdown by RNAi increased the expression of snail and slug genes and induced EMT. Inhibition of protein tyrosine phosphatase with sodium vanadate, which greatly increased the levels of tyrosine-phosphorylated IRS-1, suppressed TGF-beta1-induced actin remodeling and cell morphologic changes. These results show for the first time that TGF-beta1 induces EMT through mechanisms involving the modulation of IRS-1 signaling, and that IRS-1 functions as a critical EMT suppressor that suppresses TGF-beta1-induced EMT via inhibition of snail and slug expression.
Epidemic Neuromyasthenia
Authors: Robert M. Albrecht, Virginia L. Oliver, David C. Poskanzer
Journal: JAMA (1964)

An unusual, nonfatal illness characterized by a prolonged, relapsing course occurred over a seven-month period in 26 of 69 nuns (38%). Symptoms were fatigue, weakness, low-grade fever, nausea, headache and pain in trunk or limbs, emotional instability, depression, impaired thinking, and paresthesias. Abnormal laboratory findings in a few cases included elevated spinal-fluid cell counts, relative lymphocytosis in the peripheral blood, and elevated erythrocyte sedimentation rate. Marked creatinuria was found in four patients studied for this abnormality. Abnormal creatine excretion suggests that muscle involvement is an important and objective finding.