tbuckley/cabot-search huggingface dataset:
Randomised trials of secondary prevention programmes in coronary heart disease: systematic review
Authors: F. A McAlister, F. M E Lawson, K. K Teo, P. W Armstrong
Journal: BMJ (2001)

<h3>Abstract</h3> <b>Objective:</b> To determine whether multidisciplinary disease management programmes for patients with coronary heart disease improve processes of care and reduce morbidity and mortality. <b>Data sources:</b> Randomised clinical trials of disease management programmes in patients with coronary heart disease were identified by searching Medline 1966-2000, Embase 1980-99, CINAHL 1982-99, SIGLE 1980-99, the Cochrane controlled trial register, the Cochrane effective practice and organisation of care study register, and bibliographies of published studies. <b>Data extraction:</b> Studies were selected and data were extracted independently by two investigators, and summary risk ratios were calculated by using both the random effects model and the fixed effects model. <b>Data synthesis:</b> A total of 12 trials (9803 patients with coronary heart disease) were identified. Disease management programmes had positive impacts on processes of care. Patients randomised to these programmes were more likely to be prescribed efficacious drugs (risk ratio 2.14 (95% confidence interval 1.92 to 2.38) for lipid lowering drugs, 1.19 (1.07 to 1.32) for β blockers, and 1.07 (1.03 to 1.11) for antiplatelet agents). Five out of seven trials evaluating risk factor profiles showed significantly greater improvements with these programmes in comparison with usual care (with effect sizes in the moderate range). Summary risk ratios were 0.91 (0.79 to 1.04) for all cause mortality, 0.94 (0.80 to 1.10) for recurrent myocardial infarction, and 0.84 (0.76 to 0.94) for admission to hospital. Five of the eight trials evaluating quality of life or functional status reported better outcomes in the intervention arms. Only three of these trials reported the costs of the intervention—the interventions were cost saving in two cases. <b>Conclusions:</b> Disease management programmes improve processes of care, reduce admissions to hospital, and enhance quality of life or functional status in patients with coronary heart disease. The programmes9 impact on survival and recurrent infarctions, their cost effectiveness, and the optimal mix of components remain uncertain. <h3>What is already known on this topic</h3> Evidence based cardiac rehabilitation programmes of varying intensity improve morbidity and mortality in survivors of myocardial infarction Patients with coronary heart disease are increasingly referred to multidisciplinary clinics that use disease management approaches <h3>What this study adds</h3> Disease management approaches have a positive impact on processes of care (prescription of proved efficacious drugs and cardiovascular risk profiles of patients) Most of the trials reported that quality of life or functional status was better in patients treated with disease management rather than usual care The optimal mix of components and the cost effectiveness of these programmes is still uncertain
Distribution and release of epidermal growth factor in man.
Authors: J W Konturek, W Bielanski, S J Konturek, J Bogdal, J Oleksy
Journal: Gut (1989)

Epidermal growth factor (EGF) is localised in man to salivary and Brunner's glands. It is present in large concentrations in saliva and duodenal contents but the mechanisms of its release have been little studied. This study carried out on four groups of healthy subjects was designed to determine the distribution and the release of immunoreactive EGF (IR-EGF) in salivary, gastric, duodenal, and pancreatic secretions. Under basal conditions, the concentrations of IR-EGF in salivary, gastric, duodenal and pancreatic secretions were; 2.7 (0.4), 0.42 (0.12), 21 (5) and 8.5 (1.2) ng/ml, respectively. Chewing of Parafilm* significantly increased salivary but not gastric or duodenal EGF output while atropinisation led to the reduction in basal salivary and duodenal EGF output without affecting the increment in EGF release induced by chewing. Cigarette smoking caused a marked reduction in basal salivary and duodenal EGF output. Infusion of pentagastrin increased salivary and duodenal EGF output and this was blocked by the addition of somatostatin. Injection of secretin lead to an increase in pancreatic output of EGF. We conclude that in man the major sources of EGF are salivary glands, duodenum, and pancreas and that the release of EGF remains under neurohormonal control.
Should colonoscopy be the first investigation for colonic disease?
Authors: D C Lindsay, J G Freeman, I Cobden, C O Record
Journal: BMJ (1988)

Many patients with suspected colonic disease undergo rigid sigmoidoscopy, barium enema examination, and ultimately total colonoscopy, but the need for preliminary radiology has not been formally assessed. A total of 168 patients requiring large bowel investigation were therefore randomised to undergo either rigid sigmoidoscopy plus double contrast barium enema examination or total colonoscopy. Disease was found in 56 patients, including 14 with a carcinoma, 11 with polyps, and 16 with inflammatory bowel disease, the remainder having diverticular disease alone. Of the 89 patients allocated to double contrast barium enema examination, nine required a subsequent colonoscopy for suspected tumour or polyps, three because of incomplete radiological examination, and 12 for rectal bleeding for which no cause was found at the radiological examination. In 16 patients this yielded further information or altered treatment. Of the 79 patients undergoing total colonoscopy, only six required subsequent radiology. As both procedures were well tolerated with no major complications total colonoscopy may be the preferred initial investigation where facilities allow.
The Challenge of Developing Quality Measures for Breast Cancer Surgery
Authors: Monica Morrow, Steven J. Katz
Journal: JAMA (2012)

LTHOUGH THE TREATMENT OF CANCER IS INCREASingly multimodal, virtually all patients with solid tumors undergo surgery. In breast cancer, survival after mastectomy, or breast-conserving surgery (BCS) and radiotherapy, are equivalent, 1 and both surgical approaches have a negligible risk of major adverse events. Surgical quality performance measures for cancer have generally focused on 30-day morbidity and mortality rates for higher-risk procedures such as pancreatectomy and esophagectomy. 2 Thus, breast surgery has largely been excluded from the cancer surgical procedures for which quality measures have been developed. Indeed, the focus of quality improvement in breast cancer has primarily been on process measures tied to nonsurgical treatments, including systemic therapies and radiation. 3
Hazard of Self-inflating Resuscitation Bag
Authors: D. R. Garbe
Journal: BMJ (1971)

staff and a very different atmosphere from the acute wards.My own experience of geriatric long-stay wards, some with a high proportion of demented patients, is that eventually some trained staff are found who derive much satisfaction from their work.They have to learn to organize them more like homes and not to compete with the acute wards.The geriatrician does not have to spend much time in the long-stay units, but he must set the pattern and have control of admission.This difference of view is a minor matter, however, compared with our general agreement on the development of medical services for elderly people and on the great need for doctors to interest themselves in this field-I am, etc.,
Ozone Inhalation Induces Epithelial IL-33 and Thymic Stromal Lymphopoietin (TSLP) and Leads To Eosinophilic Airway Inflammation
Authors: Stephanie Kubala, Moyar Q. Ge, Imre Redai, Monica Soni, Bei Chen, Qi Yang, Avinash Bhandoola, Noam A. Cohen, Angela Haczku
Journal: Journal of Allergy and Clinical Immunology (2014)
Quantitative Assay of a Plasma Factor Deficient in von Willebrand's Disease that is Necessary for Platelet Aggregation. RELATIONSHIP TO FACTOR VIII PROCOAGULANT ACTIVITY AND ANTIGEN CONTENT
Authors: Harvey J. Weiss, Leon W. Hoyer, Frederick R. Rickles, André Varma, John Rogers
Journal: Journal of Clinical Investigation (1973)

In a previous paper, we showed that the abnormality of ristocetin-induced platelet aggregation in platelet-rich plasma in 10 patients with von Willebrand's disease could be corrected by a factor in normal plasma that was present in the same fractions as factor VIII procoagulant activity (antihemophilic factor, AHF, VIIIAHF) when prepared by chromatography on Bio-Gel 5 M (Bio-Rad Laboratories, Richmond, Calif.). This observation suggests that patients with this disorder are deficient in a plasma factor, associated with the factor VIII molecule, that is necessary for normal platelet function. In the present paper, we describe, an assay for this factor, the von Willebrand factor (VIIIVWF), based on the observation that a log-log relationship exists between the amount of ristocetin-induced aggregation of washed, normal platelets and the concentration of normal plasma present in the test system. We assayed the activity of VIIIVWF as well as antihemophilic factor procoagulant activity (VIIIAHF) and factor VIII antigen (VIIIAGN) in 15 patients with von Willebrand's disease and 20 normal subjects. A highly significant correlation (r ∼ 0.80) between VIIIVWF and both VIIIAHF was found in normal subjects and in patients with von Willebrand's disease. This finding, in addition to the observation that agarose gel chromatography fractions that have VIIIAHF procoagulant activity also have VIIIVWF activity, strongly suggests that the von Willebrand factor is associated with the factor VIII molecule. VIIIVWF in normal plasma was not inhibited by human anti-VIII, and VIIIVWF levels were normal in hemophilic plasma. Thus, the VIIIVWF site on the factor VIII molecule appears to be different from that determining VIIIAHF. Finally, the activity of VIIIVWF appeared to correlate better with the bleeding time than either VIIIAHF or VIIIAGN. This suggests that VIIIVWF assayed in this study may be the "anti-bleeding factor" that is deficient in von Willebrand's disease. These findings are consistent with a decreased synthesis of the factor VIII molecule in von Willebrand's disease and suggest the possibility of additional abnormalities of the site on the molecule that determines the activity of VIIIVWF.
'CSF Viral Cultures'-Reply
Authors: Marilyn A. Menegus
Journal: JAMA (1982)

<h3>In Reply.—</h3> Dr King's data are most interesting and reemphasize the need for rapid viral diagnosis if patient management is to be affected. In most cases, antibiotic therapy can be discontinued when bacterial cultures have been negative for 48 to 72 hours. It is sometimes necessary, however, to continue antibiotic therapy because of a questionable Gram stain of CSF, the contamination of CSF or blood cultures, or the presence of multisystem disease with disseminated intravascular coagulopathy. We also agree that the clinical relevance of viral cultures is largely a function of the viral diagnostic laboratory and the clinicians' use thereof. Appropriate specimens handled in an optimal manner will result in better patient care.
52 CONSTITUTIVE ACTIVATION OF THE NOTCH SIGNALING PATHWAY INDUCES THE FORMATION OF INTRAHEPATIC CHOLANGIOCELLULAR CARCINOMAS BY DEREGULATING CYCLIN E EXPRESSION
Authors: S. Zender, I. Nickeleit, M. El-Khatib, R. Geffers, S. Chauhan, S. Kubicka, H. Bektas, M.P. Manns, A. Gossler, L. Wilkens, R. Plentz, N.P. Malek
Journal: Journal of Hepatology (2011)
The relative clinical effectiveness of ranibizumab and bevacizumab in diabetic macular oedema: an indirect comparison in a systematic review
Authors: J. A. Ford, A. Elders, D. Shyangdan, P. Royle, N. Waugh
Journal: BMJ (2012)

<b>Objective</b> To indirectly compare the effectiveness of ranibizumab and bevacizumab in the treatment of diabetic macular oedema. <b>Design</b> Systematic review and indirect comparison. <b>Data sources</b> Medline (1996–September 2011), Embase (1996–September 2011), and the Cochrane Central Register of Controlled Trials (Issue 4, 2011). <b>Selection criteria for studies </b>Randomised trials evaluating ranibizumab or bevacizumab in diabetic macular oedema with a common comparator and sufficient methodological similarity to be included within an indirect comparison were eligible for inclusion. <b>Main outcome measures</b> The primary outcome was the proportion of patients with an improvement in best corrected visual acuity of more than two lines on the Early Treatment Diabetic Retinopathy Study (ETDRS) scale. Secondary outcomes included mean changes in best corrected visual acuity and in central macular thickness, and adverse events. Best corrected visual acuity was converted to logMAR units, a linear scale of visual acuity with positive values representing increasing visual loss. Indirect comparisons were done using Bayesian methods to estimate relative treatment effects of bevacizumab and ranibizumab. <b>Results</b> Five randomised controlled trials with follow-up of 6–12 months and a common comparator (multiple laser treatment) were sufficiently similar to be included in the indirect comparison. Generally studies were small, resulting in wide credible intervals. The proportions of patients with an improvement in best corrected visual acuity of &gt;2 lines were 21/77 participants (27%) for bevacizumab and 60/152 participants (39%) for ranibizumab (odds ratio 0.95 (95% credible interval 0.23 to 4.32)). The wide credible intervals cannot exclude a greater improvement, or worse outcome, for either drug. The mean change in best corrected visual acuity non-significantly favoured bevacizumab (treatment effect −0.08 logMAR units (−0.19 to 0.04)). The difference in mean change in central macular thickness was not statistically significant between ranibizumab and bevacizumab (treatment effect −6.9 μm (−88.5 to 65.4)). <b>Conclusions</b> Results suggest no difference in effectiveness between bevacizumab and ranibizumab, but the wide credible intervals cannot exclude the possibility that either drug might be superior. Sufficiently powered, direct head to head trials are needed.
Chronicle of a Health Crisis: Global Implications of the 2008 Melamine Event
Authors: Tanya Tillett
Journal: Environmental Health Perspectives (2009)

Nanotechnology holds the promise of vastly expanding our ability to clean up hazardous waste sites and decontaminate polluted groundwater in situ.Polychlorinated biphenyls, organic solvents, petroleum products, arsenic, and many more contaminants are on the list that specifically engineered nanoparticles could rapidly remove from contaminated soil and water, saving billions of dollars that would have been spent on more expensive conventional remediation methods.These possibilitites are discussed in a review of field tests using nanomaterials [EHP 117:1823-1831; Karn et al.].However, the authors caution, our knowledge of the potential environmental and health hazards posed by these nanomaterials is in its infancy.In the United States alone there are hundreds of thousands of sites contaminated with hazardous wastes, with more than 1,200 requiring priority attention.Using traditional remediation technologies, such as pumping out and treating contaminated groundwater and removing contaminated soil, the job of cleaning up U.S. hazardous waste sites could take 35 years and $250 billion.The authors of this review, however, report on results showing that nanoscale zero-valent iron (nZVI) nanoparticles could dramatically reduce the time required to remediate soil and water as well as, according to one report, save 80-90% compared with conventional methods.Although tiny in diameter, the surface area of these iron-based nanoparticles reaches 20-40 m 2 /g.This relatively large surface area can greatly increase the particles' reactivity.Flowing with the groundwater they can spread out to react with pollutants, transforming them into safer compounds, including compounds that bacteria can break down.The authors provide many examples of how nZVIs, currently the nano materials most widely used for in situ remediation, produced measurable effects within days or, in some cases, hours.However, the authors also emphasize that we do not know much about the potential adverse effects of nanoparticles deployed into the environment-agents that could, for example, end up in our drinking water.Some nanomaterials have already been found to enter organisms.Might some be toxic or transport bound pollutants to places they might not other wise have gone?Can they be biomagnified?How do they affect living organisms?The authors point out that, although the environment is full of naturally occurring nanoparticles, manufactured nanoparticles may behave in unpredictable ways.They recommend that while we improve engineering applications using nanoparticles for in situ remediation, we also develop the analytical tools to enable the study of manufactured nanoparticles in the environment and increase research on the ecosystem effects of these materials.
583. The Transgene Expression in the Lung after Systemic Injection of DNA Formulated into Nanoparticles with Linear PEI Depends of Bolus Effect and the Presence of Free PEI
Authors: Jean Luc Coll, Olivier Freund, Alain Cuzange, Jean Serge Remy, Jean Paul Behr, Patrick Erbacher
Journal: Molecular Therapy (2005)
Actinic prurigo and polymorphic light eruption: common pathogenesis and the importance of HLA-DR4/DRB1*0407
Authors: None GRABCZYNSKA, None MCGREGOR, None KONDEATIS, None VAUGHAN, None HAWK
Journal: British Journal of Dermatology (1999)

Actinic prurigo (AP) and polymorphic light eruption (PLE) both belong to the group of idiopathic photodermatoses, but it remains controversial whether AP is a distinct photodermatosis or a variant of PLE. The aim of this study, by collecting data from 119 patients with features of these disorders, was to establish whether specific criteria could be used to distinguish AP from PLE prospectively. We found that presence of the eruption on both exposed and covered sites, its occurrence in winter, persistence of lesions beyond 4 weeks, mucosal and conjunctival involvement, excoriation and scarring of the skin were important features of AP which were not typical of PLE. On this basis, confident clinical diagnoses could be reached in 103 of 119 patients (87%), 57 with AP and 46 with PLE, supported by phototesting and negative lupus serology. HLA typing subsequently confirmed the strong association (90%) between AP and the DR4 allele, in particular with the rare subtype DRB1*0407 which was present in 60% of these patients. No HLA association was found in PLE. In the 16 remaining cases, however, clinical overlap meant that no definite diagnosis could be made; these patients were notionally described as having persistent PLE (PPLE). Demographic and HLA data in this group suggested that PPLE was perhaps most appropriately grouped with PLE. In addition to those patients who were difficult to classify, 35% of our typical AP patients also described clinical progression from PLE to AP, AP to PLE or coexistence of both AP and PLE. In conclusion, our study suggests that while AP and PLE are clinically distinct conditions in most cases, they may perhaps share a common pathophysiological basis. The AP phenotype may be determined by HLA and perhaps other factors in patients otherwise predisposed to PLE.
Abstract 3356: Comparative plasma and cerebrospinal (CSF) pharmacokinetics (PK) of vincristine sulfate standard preparation (VCR) and vincristine sulfate liposomes injection (VSLI) in a non-human primate (NHP) model.
Authors: Diane E. Cole, Cynthia M. Lester-McCully, Nirali N. Shah, Katherine E. Warren, Alan S. Wayne, Brigitte C. Widemann
Journal: Cancer Research (2013)

Abstract Background: Vincristine has been used as standard therapy for adult and pediatric malignancies for 50 years. Cumulative neurotoxicity often requires capping the maximum single and cumulative VCR dose. VSLI is a novel preparation of VCR encapsulated in sphingomyelin/cholesterol liposomes. Following clinical trials that demonstrated safety, tolerability and efficacy in adults with relapsed/refractory acute lymphoblastic leukemia, VSLI has been granted FDA accelerated approval at a dose of 2.25 mg/m2given once weekly for that population. A pediatric Phase I trial is ongoing. We evaluated plasma and CSF PK of intravenously (IV) administered VCR and total VSLI (liposomal encapsulated and non-encapsulated) in our NHP model. Methods: 0.1 mg/kg (1.2 mg/m2 human-equivalent dose) VCR over 1 minute or VSLI over 15 minutes was administered on separate occasions to each of 3 adult rhesus monkeys (Macaca mulatta). Serial paired plasma and CSF samples were collected for up to 48 hrs. Drug concentrations were quantified using HPLC/tandem mass spectrometry assays. For plasma samples, VCR standard curves were linear over a range of .0025-10.0 μg/ml (lower limit of quantification, .0025 μg/ml). Lower limit of detection for VCR in NHP CSF was .001 μg/ml. PK parameters were estimated using non-compartmental methods. Results: Plasma PK parameters (median and range) for VCR and VSLI Cmax (μg/ml) AUC0-infinity (μg*hr/ml) Cl (ml/min) Terminal T1/2 (hours) VCR 1.07 (0.99–2.1) 0.614 (0.336–0.676) 33.8 (29.6–54) 24.3 (14.2–54.4) VSLI 4.8 (3.7–7.3) 195 (163–312) 0.089 (0.073–0.113) 17.9 (13.9–21.5) Cmax = maximal concentration, AUC = area under the concentration x time curve, Cl = clearance, T1/2 = half life VCR demonstrated a multi-exponential and VSLI a near-monoexponential plasma concentration versus time curve. The ratios ClVCR: ClVSLI for the individual NHP were 300, 463 and 477. Vincristine was not detected in any CSF sample. Conclusions: The NHP model allowed for a direct comparison of VCR and VSLI PK. VCR Cl exceeds that of VSLI by approximately 400-fold. No penetration into the CSF was observed for either preparation. Citation Format: Diane E. Cole, Cynthia M. Lester-McCully, Nirali N. Shah, Katherine E. Warren, Alan S. Wayne, Brigitte C. Widemann. Comparative plasma and cerebrospinal (CSF) pharmacokinetics (PK) of vincristine sulfate standard preparation (VCR) and vincristine sulfate liposomes injection (VSLI) in a non-human primate (NHP) model. [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 3356. doi:10.1158/1538-7445.AM2013-3356
Endemic pemphigus foliaceus in western Parana, Brazil (1976-1988)
Authors: J.C. EMPINOTTI, L.A. DIAZ, C.R. MARTINS, E.A. RIVITTI, S.A.P. SAMPAIO, C. LOMBARDI, J.A. SANCHES
Journal: British Journal of Dermatology (2006)

Endemic pemphigus foliaceus or fogo selvagem (FS) is a blistering autoimmune disease indigenous to certain states of Brazil. In the state of Parana the disease has been reported in the north-central regions where a total of 632 cases were documented in the period of 1940-80. The present study describes a new focus of FS in the western region of the state of Parana. This focus includes a total of 213 new cases of FS and only 11 cases of pemphigus vulgaris seen in this region from February 1976 to July 1988. Over 90% of these patients were peasants working in agriculture or involved in other outdoor activities.