tbuckley/cabot-search huggingface dataset:
Periodic Liver Biopsy for Mild Hepatitis C
Authors: Barry Kisloff
Journal: Annals of Internal Medicine (2001)

Letters4 September 2001Periodic Liver Biopsy for Mild Hepatitis CBarry Kisloff, MDBarry Kisloff, MDAlliance Medical; Pittsburgh, PA 15232 (Kisloff)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-135-5-200109040-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The report by Wong and Koff (1), which advocates initial interferon-ribavirin therapy for mild chronic hepatitis C, seems flawed in several ways. First, it ignores reports (2, 3) that predict a significantly lower rate of progression to cirrhosis from chronic hepatitis C than the 27.5% or even 9.5% used in their study. Inclusion of these data would probably change the outcomes reported. The failure to even mention these and other similar reports showing a more favorable outcome of chronic hepatitis C is troubling. Second, in calculating costs for the group of patients with mild hepatitis, more than ...References1. Wong J, Koff R. Watchful waiting with periodic liver biopsy versus immediate empirical therapy for histologically mild chronic hepatitis C. A cost-effectiveness analysis. Ann Intern Med. 2000;133:665-75. [PMID: 11074899] LinkGoogle Scholar2. Seeff L, Miller R, Rabkin C, Buskell-Bales Z, Straley-Eason K, Smoak B, et al . 45-year follow-up of hepatitis C virus infection in healthy young adults. Ann Intern Med. 2000;132:105-11. [PMID: 10644270] LinkGoogle Scholar3. Thomas D, Astemborski J, Rai R, Anania F, Schaeffer M, Galai N, et al . The natural history of hepatitis C virus infection: host, viral, and environmental factors. JAMA. 2000;284:450-6. [PMID: 10904508] CrossrefMedlineGoogle Scholar4. McHutchison J, Gordon S, Schiff E, Shiffman M, Lee W, Rustgi V, et al . Interferon alfa-2b alone or in combination with ribavirin as initial treatment for chronic hepatitis C. Hepatitis Interventional Therapy Group. N Engl J Med. 1998;339:1485-92. [PMID: 9819446] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Alliance Medical; Pittsburgh, PA 15232 (Kisloff) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoWatchful Waiting with Periodic Liver Biopsy versus Immediate Empirical Therapy for Histologically Mild Chronic Hepatitis C: A Cost-Effectiveness Analysis John B. Wong and Raymond S. Koff Periodic Liver Biopsy for Mild Hepatitis C John B. Wong and Raymond S. Koff Metrics Cited ByCompensated hepatitis C: unenhanced MR imaging correlated with pathologic grading and staging 4 September 2001Volume 135, Issue 5Page: 381KeywordsBiopsyChronic hepatitis CCirrhosisHepatitisHepatitis CHepatitis C virusInfectious hepatitisLiverPatient advocacy ePublished: 4 September 2001 Issue Published: 4 September 2001 CopyrightCopyright © 2001 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Pressure Fields by Flow-Sensitive, 4D, Velocity-Encoded CMR in Patients With Aortic Coarctation
Authors: Eugénie Riesenkampff, Joao Filipe Fernandes, Sebastian Meier, Leonid Goubergrits, Siegfried Kropf, Stephan Schubert, Felix Berger, Anja Hennemuth, Anja Henneumuth, Titus Kuehne
Journal: JACC. Cardiovascular imaging (2014)
The Theory and Practice of Public Health
Authors: George L. Fite
Journal: JAMA (1966)

It is difficult to evaluate for the American reader a textbook designed for British consumption, particularly if the life-backgrounds on which the work is founded are at variance within the two countries. Living conditions in the British Isles reflect a public health practice somewhat different from that in the United States. Working under differing laws and conventions, if one reads correctly between the lines, the national medical practice acts of Great Britain are coming to have a reflexive effect on public health teachings and programs. Then, too, there is a difference in the educational progression of the medical student, suggested by the somewhat elementary treatment given in this book to many topics. Since the student of public health for whom this work is apparently designed is not too far along in his education, this readable, well-printed, and reasonably up-to-date volume is limited in depth, even while the scope of the
Study of the Tumor Marker Carbohydrate Antigen 50 in Liver Cirrhosis
Authors: JULIO COLLAZOS, JOSE GENOLLA, ALVARO RUIBAL
Journal: Clinical Nuclear Medicine (1993)

Carbohydrate antigen 50 (CA 50) is a tumor marker that increases in many malignancies, especially in carcinoma of the digestive tract. False-positive results occur in benign liver disease. The behavior of CA 50 in 86 cirrhotic patients was studied, with thorough clinical and laboratory evaluations. There were abnormal values in 75.6% of the patients without significant differences among the different Child's grades. Significant correlations with some liver tests were found, especially transaminases, and at lower degrees with cholestatic parameters. Despite the previously reported relation with cholestasis, especially in biliary diseases, the CA 50 serum levels of the authors' cirrhotic patients appeared to be more closely related to cytolysis, according to the results of several statistical tests, including multivariate analysis. Because of the percentage and the levels of the abnormal results, this antigen cannot be used as a tumor marker in cirrhotic patients. Cytolysis seems to have a pathogenetic role in the increase of CA 50, at least in cirrhosis.
Preserved Spontaneous Breathing Improves Cardiac Output during Partial Liquid Ventilation
Authors: AXEL R. FRANZ, CHRISTINA MACK, JULIA REICHART, FRANK POHLANDT, HELMUT D. HUMMLER
Journal: American Journal of Respiratory and Critical Care Medicine (2001)

The aim of this study was to examine whether preserved spontaneous breathing (SB) supported by proportional-assist ventilation (PAV) would improve cardiac output (CO) during partial liquid ventilation (PLV) in rabbits with and without lung disease if compared with time-cycled, volume-controlled ventilation (CV) combined with muscle paralysis (MP). PLV was initiated in 17 healthy rabbits and 17 surfactant-depleted rabbits using 12 to 15 ml/kg of perfluorodecaline. Both ventilatory modes, SB + PAV and CV + MP, were applied in random sequence using a crossover design. CO was measured by thermodilution. CO was significantly higher during SB + PAV than during CV + MP: 136 ± 21 ml/kg min (mean ± SD) versus 120 ± 30 ml/kg min (p = 0.004) in healthy rabbits, and 147 ± 19 ml/kg min versus 111 ± 13 ml/kg min (p < 0.0001) in surfactant-depleted rabbits, resulting in an improved oxygen delivery. This difference was mainly caused by a larger stroke volume during SB + PAV, whereas there was little change in heart rate. In surfactant-depleted rabbits, SB + PAV resulted in improved arterial blood pressure and arterial and mixed venous pH and in a higher PaO2 at the same level of PEEP and mean airway pressure. We conclude that during PLV, CO is higher during SB + PAV than during CV + MP, resulting in an improved oxygen delivery. In surfactant-depleted rabbits, improved CO, oxygen delivery, and arterial blood pressure resulted in higher pH, possibly reflecting improved tissue perfusion and oxygenation.Keywords: Fluorocarbons; ventilation, mechanical; respiration, artificial; hemodynamics; cardiac output; paralysis
Clarification in law is sought after man is jailed for infecting partner with genital herpes
Authors: C. White
Journal: BMJ (2011)

The sentencing of a UK man to a 14 month prison term for infecting his former partner with genital herpes has prompted calls for an amendment to the existing legislation.

It is the first time that the law on deliberate transmission of a sexually transmitted infection has been applied to genital herpes.

David Golding, who entered a plea of grievous bodily harm after being arrested for assault, was found guilty of “reckless transmission of an incurable sexually transmitted infection” under the Offences against the Person Act 1861.

His former partner had been given a diagnosis of genital herpes after entering into a relationship with him. He had failed to disclose his previous history of infection.

Meting out the sentence at …
Patients should receive copies of letters and summaries
Authors: C. Chantler
Journal: BMJ (2002)

EDITOR—In 2000 we attended a meeting to discuss how to improve healthcare delivery within the NHS.1 One of the recommendations was that patients, except in special circumstances, should receive copies of all letters, case summaries, or care plans written by doctors or other clinicians. We also suggested that with the patient's approval such material should be stored on a central server. The suggestion was accepted and …
p38 MAP kinase is a mediator of ischemic preconditioning in pigs
Authors: R Schulz
Journal: Cardiovascular Research (2002)

Objective: The role of p38MAPK in ischemic preconditioning (IP) is still equivocal, insofar as the p38MAPK-inhibitor SB203580 abolished IP in rats, rabbits and dogs, but not in pigs. Blockade of p38MAPK prior to the sustained ischemia also generated contradictory findings, insofar as p38MAPK acted as trigger in dogs but as mediator in rats. We have now tested whether the two structurally unrelated p38MAPK-inhibitors, BIX-645 and SB203580, abolished infarct size (IS) reduction by IP in pigs and whether their effects depended on the time of administration. Methods: Sixty-five enflurane-anesthetized pigs underwent 90 min low-flow ischemia and 120 min reperfusion without or with one preceding cycle of 10 min preconditioning ischemia and 15 min reperfusion. Pigs received BIX-645 (1 mg/kg, i.v.) or SB203580 (10 μM, i.c.) prior to either IP or the sustained ischemia. Results: IS (% TTC-staining) was reduced by IP [4.8±3.1(S.E.M.), P<0.05] compared to placebo (25.8±5.5). BIX-645 or SB203580 per se had no effect on IS (23.5±5.2 and 21.8±4.4, respectively). IS reduction by IP was abolished by BIX-645 (26.2±6.4 or 25.5±4.7) and SB203580 (19.9±4.3 or 16.7±4.7), given either prior to IP or the sustained ischemia, respectively. The supernatant of homogenized myocardial biopsies taken during the sustained ischemia from preconditioned pigs receiving either BIX-645 or SB203580 inhibited the anisomycin-stimulated ATF-2 phosphorylation in cultured Rat1 fibroblasts. This in vitro inhibition of ATF-2 phosphorylation correlated to the actual IS. Conclusion: The attenuation of the IS-reducing effect of IP depends on the effectiveness of blockade of p38MAPK activity. p38MAPK is a mediator of IP in pigs.
Fluorescence In Situ Hybridisation in the Diagnosis of Upper Urinary Tract Tumours
Authors: Christine Mian, Guido Mazzoleni, Silke Vikoler, Thomas Martini, Ruth Knüchel-Clark, Dirk Zaak, Alexander Lazica, Stephan Roth, Michael Mian, Armin Pycha
Journal: European Urology (2010)
1036 SERPINB3 INCREASES RESISTANCE TO CHEMOTHERAPEUTIC AGENTS INHIBITING ROS PRODUCTION AND THE PERMEABILITY TRANSITION PORE
Authors: F. Ciscato, M. Sciacovelli, M.G. Ruvoletto, C. Turato, S. Quarta, G. Villano, A. Gatta, P. Bernardi, A. Rasola, P. Pontisso
Journal: Journal of Hepatology (2013)
Diagnosis of urogenital Chlamydia trachomatis infection in women based on mailed samples obtained at home: multipractice comparative study
Authors: L. Ostergaard, J. K Moller, B. Andersen, F. Olesen
Journal: BMJ (1996)

<h3>Abstract</h3> <b>Objective</b>: To compare urine and vaginal flush samples collected by women at home with endocervical and urethral swabs obtained by general practitioners for their efficacy in the diagnosis of urogenital Chlamydia trachomatis infection. <b>Design</b>: Multipractice comparative study. <b>Setting</b>: 33 general practices and a central department of clinical microbiology in Aarhus County, Denmark. <b>Subjects</b>: 222 women aged 18–25 years who for any reason had a gynaecological examination. <b>Interventions</b>: Endocervical and urethral swabs were obtained by the women9s general practitioners. The same women when at home then collected a first void urine sample, a midstream urine sample, and a vaginal flush sample (using a vaginal pipette) and mailed them to the laboratory. <b>Main outcome measures</b>: C trachomatis detected by the polymerase chain reaction and the ligase chain reaction. Eight tests for C trachomatis were performed for every woman. When two of the eight yielded positive results the patient was considered infected. <b>Results</b>: The overall prevalence of C trachomatis infection was 11.2% (23/205 women). Test sensitivities in samples obtained by general practitioners, samples obtained at home subjected to polymerase chain reaction, and samples obtained at home subjected to ligase chain reaction were 91%, 96%, and 100% respectively. The corresponding specificities were 100%, 92.9%, and 99.5%. <b>Conclusions</b>: The diagnostic efficacy of samples obtained by women at home and mailed to the laboratory was as good as for samples obtained by a general practitioner when using the ligase chain reaction. This may have important implications for the practicability of screening for this common, often asymptomatic, and treatable infection. <h3>Key messages</h3> A combination of mailed samples obtained at home is necessary in order to obtain optimal diagnostic sensitivity; a single urine sample is not enough Mailed samples obtained at home may also be appropriate for diagnosis in young asymptomatic women with regular partners; these women have a high prevalence of urogenital C trachomatis infection The use of mailed self obtained samples in women might limit costs and increase the practicability of screening programmes for urogenital C trachomatis infection
Primary care is not urgent care, and we need more urgent care
Authors: D. J. Albert
Journal: BMJ (2015)

Loxterkamp argues that general practices are better than urgent care centres for treating urgent problems.1 This has relevance in the UK. The current government was advised by GPs who shared Loxterkamp’s view and closed down many GP led (Darzi) health centres. This made neither economic nor ethical sense.

A recent survey showed that the Sheffield Darzi centre …
Nicotine Replacement in Smoking Cessation
Authors: Michael A. H. Russell
Journal: JAMA (1987)

Nicotine replacement is a promising new approach to aid smoking cessation, and various methods of delivery are being developed. One new device is a smoke-free cigarette (Favor) that has been test-marketed in several US states. Without lighting up, it delivers nicotine vapor and is free of other harmful products of tobacco smoke. To examine its therapeutic potential, we measured plasma nicotine concentrations before, during, and after its use in eight male subjects. Very little nicotine was absorbed when it was puffed like a conventional cigarette. However, with an intensive schedule of puffing at four further smoke-free cigarettes over a 20-minute period, plasma nicotine concentrations were increased by an average of 17.3 ng/mL (107.3 nmol/L) (range, 10.9 to 30.4 ng/mL [67.6 to 188.5 nmol/L]). Heart rate and blood pressure also increased significantly. The rate of nicotine absorption was slow and resembled that obtained from nicotine chewing gum, suggesting that most of the nicotine was deposited in the mouth, throat, and large airways and did not reach the lung alveoli. Despite the slow absorption, the plasma nicotine levels produced could be of therapeutic value as an aid to smoking cessation. (<i>JAMA</i>1987;257:3262-3265)
New Rapid Test for Pheochromocytoma
Authors: Robert L. Wolf, Milton Mendlowitz, Stanley E. Gitlow
Journal: JAMA (1964)

A new chromatoelectrophoretic urine test based on the quantitative assay of normetanephrine (NM), metanephrine (M), and 3-methoxy-4-hydroxyphenylglycol (G) in a casual urine specimen was used to detect pheochromocytomas. Urine specimens from 40 patients with pheochromocytoma, 50 normotensive subjects, and 25 primary benign hypertensive subjects were analyzed for NM, M, and G using the chromoelectrophoretic test, and the results compared with other tests for pheochromocytoma based on the urinary assay for 3-methoxy-4-hydroxymandelic acid (VMA). Correct results were obtained in all specimens with the chromatoelectrophoretic test as opposed to several equivocal results with the tests that analyze for VMA.
Effect of Enhanced Information, Values Clarification, and Removal of Financial Barriers on Use of Prenatal Genetic Testing
Authors: Miriam Kuppermann, Sherri Pena, Judith T. Bishop, Sanae Nakagawa, Steven E. Gregorich, Anita Sit, Juan Vargas, Aaron B. Caughey, Susan Sykes, Lasha Pierce, Mary E. Norton
Journal: JAMA (2014)

<h3>Importance</h3> Prenatal genetic testing guidelines recommend providing patients with detailed information to allow informed, preference-based screening and diagnostic testing decisions. The effect of implementing these guidelines is not well understood. <h3>Objective</h3> To analyze the effect of a decision-support guide and elimination of financial barriers to testing on use of prenatal genetic testing and decision making among pregnant women of varying literacy and numeracy levels. <h3>Design, Setting, and Participants</h3> Randomized trial conducted from 2010-2013 at prenatal clinics at 3 county hospitals, 1 community clinic, 1 academic center, and 3 medical centers of an integrated health care delivery system in the San Francisco Bay area. Participants were English- or Spanish-speaking women who had not yet undergone screening or diagnostic testing and remained pregnant at 11 weeks’ gestation (n = 710). <h3>Interventions</h3> A computerized, interactive decision-support guide and access to prenatal testing with no out-of-pocket expense (n = 357) or usual care as per current guidelines (n = 353). <h3>Main Outcomes and Measures</h3> The primary outcome was invasive diagnostic test use, obtained via medical record review. Secondary outcomes included testing strategy undergone, and knowledge about testing, risk comprehension, and decisional conflict and regret at 24 to 36 weeks’ gestation. <h3>Results</h3> Women randomized to the intervention group, compared with those randomized to the control group, were less likely to have invasive diagnostic testing (5.9% vs 12.3%; odds ratio [OR], 0.45 [95% CI, 0.25-0.80]) and more likely to forgo testing altogether (25.6% vs 20.4%; OR, 3.30 [95% CI, 1.43-7.64], reference group screening followed by invasive testing). Women randomized to the intervention group also had higher knowledge scores (9.4 vs 8.6 on a 15-point scale; mean group difference, 0.82 [95% CI, 0.34-1.31]) and were more likely to correctly estimate the amniocentesis-related miscarriage risk (73.8% vs 59.0%; OR, 1.95 [95% CI, 1.39-2.75]) and their estimated age-adjusted chance of carrying a fetus with trisomy 21 (58.7% vs 46.1%; OR, 1.66 [95% CI, 1.22-2.28]). Significant differences did not emerge in decisional conflict or regret. <h3>Conclusions and Relevance</h3> Full implementation of prenatal testing guidelines using a computerized, interactive decision-support guide in the absence of financial barriers to testing resulted in less test use and more informed choices. If validated in additional populations, this approach may result in more informed and preference-based prenatal testing decision making and fewer women undergoing testing. <h3>Trial Registration</h3> clinicaltrials.gov Identifier:NCT00505596
Abstract 3768: Autophagy: a mechanism of resistance to therapy in breast cancer.
Authors: Bhuvanesh Dave, Sucharita Mitra
Journal: Cancer Research (2013)

Abstract Autophagy is an evolutionarily conserved lysosomal pathway for degradation of cytoplasmic proteins, macromolecules, and organelles. It is defined as a cell survival pathway which allows cells to survive nutrient and environmental stress. Tumor initiating cells (TICs) survive radiation, endocrine therapy, and chemotherapy, making them the primary cause of relapse in breast cancer patients. Our previous studies have identified autophagy as the mechanism of survival in these treatment-resistant populations in letrozole- as well as chemotherapy-treated patient samples. In this study we confirmed our previous finding by using a real time PCR low density array of 84 genes related to autophagy in 9 paired pre- vs. post-letrozole treated clinical samples, where 60 out of 84 genes demonstrated a statically significant change (p&amp;lt;0.05). Autophagy inhibitors like N-acetyl cysteine and catalase demonstrate a significant reduction in TICs using mammosphere forming efficiency (MSFE) (p&amp;lt;0.05) and flow cytometry of CD44+/CD24- (p&amp;lt;0.05) cells in three triple negative breast cancer cell lines (MDA-MB231, SUM159 and BT549). Recent evidence from our group had determined a role for hypoxia and reactive nitrogen species in TIC inhibition. Here we demonstrate that both catalase and N-acetyl cysteine inhibit TICs by a mechanism that significantly reduces inducible nitric oxide synthase and HIF-1α, implicating both hypoxia and reactive nitrogen species in the process. We will be confirming our finding in-vivo using patient-derived and cell line human xenografts and further examine the cross talk between hypoxia and reactive nitrogen species as it relates to autophagy. The understanding of this process may allow us to target TICs in a novel mechanistic way. Citation Format: Bhuvanesh Dave, Sucharita Mitra. Autophagy: a mechanism of resistance to therapy in breast cancer. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 3768. doi:10.1158/1538-7445.AM2013-3768
The prevalence of factor V R506Q mutation-Leiden among apparently healthy Lebanese
Authors: Noha Irani-Hakime, Hala Tamim, Raghid Kreidy, Wassim Y. Almawi
Journal: American Journal of Hematology (2000)

Resistance to activated protein C (APC) degradation caused by a specific point mutation in the factor V (FV) gene, FV:R506Q or FV-Leiden, which replaces Arg506 with Gln at the APC cleavage site within the FV gene, is the most prevalent inherited caused of venous thrombosis. Recent reports suggested that the prevalence of FV-Leiden is high among Caucasians, and very low among non-Caucasians, thereby suggesting that FV-Leiden has originated as a single event in a primary focus. Insofar as FV-Leiden is associated with increased risk of thromboembolic diseases, coupled with its selective worldwide distribution, the aim of this study was to determine the prevalence of FV-Leiden in Lebanon and compare it with those of other countries of Caucasian and non-Caucasian origin. FV-Leiden was determined by PCR, followed by hybridization with specific wild-type and mutant DNA probes. By screening 174 healthy Lebanese subjects, 25 were shown to carry the FV-Leiden mutation, giving an allele frequency of 7.4% and an overall prevalence rate of 14.4%. Of the 25 FV-Leiden carriers, 24 were in the heterozygous state while one was in the homozygous states. No statistical difference in the FV-Leiden prevalence was noted with respect to age, gender, or sect. In addition to Lebanon, which had the highest prevalence rate reported thus far (14.4%), a high prevalence of FV-Leiden was reported for Syria (13.6%), Greece–Cyprus (13.4%), and Jordan (12.3%), an indication that the Eastern Mediterranean is the primary focus of FV-Leiden mutation. The high prevalence of FV-Leiden in Lebanon suggests that screening for this mutation must be considered for those with a family history, and/or those with additional risk factors for venous thrombosis. Am. J. Hematol. 65:45–49, 2000. © 2000 Wiley-Liss, Inc.