tbuckley/cabot-search huggingface dataset:
Effects of Pramlintide on Postprandial Glucose Excursions and Measures of Oxidative Stress in Patients With Type 1 Diabetes
Authors: Antonio Ceriello, Ludovica Piconi, Lisa Quagliaro, Yan Wang, Catherine A. Schnabel, James A. Ruggles, Maurice A. Gloster, David G. Maggs, Christian Weyer
Journal: Diabetes Care (2005)

OBJECTIVE—Oxidative stress has been shown to be increased in the postprandial period in patients with diabetes and has been implicated in the pathogenesis of micro- and macrovascular complications. The aim of this post hoc analysis was to assess the effects of pramlintide, an amylin analog shown to reduce postprandial glucose excursions in patients with diabetes, on markers of oxidative stress in the postprandial period. RESEARCH DESIGN AND METHODS—In a randomized, single-blind, placebo-controlled, crossover study, 18 evaluable subjects with type 1 diabetes underwent two standardized breakfast meal tests and received pramlintide or placebo in addition to their preprandial insulin. The plasma concentrations of glucose and markers of oxidative stress (nitrotyrosine, oxidized LDL [ox-LDL], and total radical-trapping antioxidant parameter [TRAP]) were measured at baseline and during the 4-h postprandial period. RESULTS—Compared with placebo, pramlintide treatment significantly reduced postprandial excursions of glucose, nitrotyrosine, and ox-LDL and prevented a decline in TRAP (P &amp;lt; 0.03 for all comparisons). Correlation analyses adjusted for treatment revealed a significant association between postprandial mean incremental area under the curve from 0 to 4 h (AUC0–4 h) for glucose and postprandial mean incremental AUC0–4 h for each measure of oxidative stress (r = 0.75, 0.54, and −0.63 for nitrotyrosine, ox-LDL, and TRAP, respectively; P &amp;lt; 0.001 for all correlations). CONCLUSIONS—These findings indicate that the postprandial glucose-lowering effect of pramlintide in type 1 diabetes is associated with a significant reduction in postprandial oxidative stress.
Some memorable advice
Authors: D D R Williams
Journal: BMJ (2001)

Advocates of protocols and guidelines find it difficult to accept that there are occasions when the best outcome is achieved by the opposite of what received wisdom generally dictates. I learnt this soon after becoming a consultant.

During our weekly assessment meeting, my occupational therapist colleague showed me a letter addressed to “The Therapist.” It was well written, short, and to the point. The author had read in the Sunday Times about “primal therapy,” a treatment that initially placed great emphasis …
Adiposity, Fractional Exhaled Nitric Oxide, and Asthma in U.S. Children
Authors: Yueh-Ying Han, Erick Forno, Juan C. Celedón
Journal: American Journal of Respiratory and Critical Care Medicine (2014)

Whether allergic airway inflammation mediates the association between overweight or obesity and childhood asthma is unknown.To examine adiposity, asthma, and fractional exhaled nitric oxide (FeNO) in U.S. children.Cross-sectional study of indicators of adiposity or obesity, FeNO (a biomarker of eosinophilic airway inflammation), and asthma in 2,681 children aged 6-17 years in the 2007-2010 National Health and Nutrition Examination Survey. Adiposity measures included body mass index (BMI), percent body fat (PBF), and waist circumference (WC).BMI, PBF, and WC were associated with asthma among children with low FeNO (odds ratio, 1.54-1.68; P < 0.01), but not among children with increased FeNO. Among children without asthma, BMI, PBF, and WC were associated with higher FEV1 and FVC, and lower FEV1/FVC. Among children with asthma and a high FeNO, all adiposity indicators were associated with decreased FEV1/FVC (β = -1.5% to -1.7% per z score) but not with FEV1 or FVC. Higher BMI or PBF was associated with worse asthma severity or control in children with asthma and increased FeNO, but not in children with asthma and low FeNO. Similar results were obtained in a secondary multivariate analysis of overweight or obesity (defined as BMI ≥85th percentile) and asthma or indicators of asthma severity or control, stratified by FeNO level.Adiposity indicators are associated with asthma in children with low FeNO. Among children with asthma, adiposity indicators are associated with worse asthma severity or control in those with high FeNO.
The effects of ambient ozone on lung function in children: a reanalysis of six summer camp studies.
Authors: P L Kinney, G D Thurston, M Raizenne
Journal: Environmental Health Perspectives (1996)

Studies of children attending summer camps often have observed relationships between daily outdoor ozone (O3) concentrations and decreased lung function that are qualitatively similar to results seen in human chamber studies. The former studies, focusing on the pulmonary effects of O3 and associated pollutants on children under natural conditions of exposure, are potentially of great importance to understanding the public health impact of ambient O3. However, a thorough assessment of the results of these studies has been hampered by differences in the analysis and reporting of data across the various studies. We obtained data sets from six summer camp studies carried out by three separate investigative groups, including two New Jersey studies performed by New York University, two studies in Ontario carried out by Health and Welfare Canada, and two studies in southern California. The data consisted of sequential, daily measurements of forced expiratory volume in 1 sec (FEV1), peak expiratory flow rate (PEFR), and 1-hr O3 concentration in the hour preceding lung function measurements for each child. We analyzed the relationships between lung function and O3 using linear regression models that fit subject-specific intercepts and a single, pooled O3 slope. These models were fit for each of the six studies separately and for all studies combined. All of the study-specific slopes of FEV1 on O3 were negative (i.e., increased O3 associated with decreased FEV1); five of six were statistically significant. Analysis of the combined six-study data set yielded a slope of -0.50 ml FEV1/ppb O3 (p<0.0001). Addition of time-trend variables to the combined-data analysis diminished, but did not eliminate, the FEV1-O3 relationship. Study-specific slopes for PEFR on O3 were more variable. Combined over studies, no significant relationship was observed between PEFR and O3. However, this negative finding appeared to be partially confounded by time trends in PEFR. The results of this reanalysis provide strong evidence that children exposed to O3 under natural conditions experience decreases in FEV1 of the kind demonstrated in laboratory studies, and raise concern that other acute respiratory effects observed in those studies (e.g., pulmonary inflammation) may also occur in young people exposed to ambient O3.
Castleman Disease of the Porta Hepatis Mimicking Exophytic Hepatocellular Carcinoma on CT, MRI, and FDG PET/CT
Authors: Aisheng Dong, Hui Dong, Changjing Zuo
Journal: Clinical Nuclear Medicine (2013)

Castleman disease is an uncommon disorder characterized by the proliferation of lymphoid tissue. We present a case of Castleman disease in the porta hepatis, showing hypervascularity on enhanced CT and MRI as well as increased FDG uptake on FDG PET/CT. These image features were similar to exophytic hepatocelluar carcinoma. This case suggests that Castleman disease should be considered as a rare differential diagnosis in patients with a perihepatic hypervascular and hypermetabolic mass.
Cancer drug sensitivity test has problems
Authors: T. Hager
Journal: JAMA (1982)

A commercially available laboratory test for predicting the chemosensitivity of tumor cells is plagued by technical problems and appears to work effectively with only a few types of cancer, according to reports delivered at the 13th International Cancer Conference in Seattle. The Human Tumor Clonogenic Assay (HTCA)— also known as the human tumor stem cell assay—is an in vitro test designed to show whether a specific tumor is sensitive or resistant to a battery of anticancer drugs. In a manner analogous to bacterial sensitivity tests used for assigning antibiotics, HTCA results are now being used by some oncologists to tailor chemotherapy to the needs of individual patients. But a number of tumor types don't grow well—and leukemias and lymphomas don't grow at all—under the culture conditions used in the test. In addition, a National Cancer Institute (NCI) study has shown that HTCA is not sensitive to the effects of six
Antimalarial effects of peptide inhibitors of a Plasmodium falciparum cysteine proteinase.
Authors: P J Rosenthal, W S Wollish, J T Palmer, D Rasnick
Journal: Journal of Clinical Investigation (1991)

We previously identified a Plasmodium falciparum trophozoite cysteine proteinase (TCP) and hypothesized that it is required for the degradation of host hemoglobin by intraerythrocytic malaria parasites. To test this hypothesis and to evaluate TCP as a chemotherapeutic target, we examined the antimalarial effects of a panel of peptide fluoromethyl ketone proteinase inhibitors. For each inhibitor, effectiveness at inhibiting the activity of TCP correlated with effectiveness at both blocking hemoglobin degradation and killing cultured parasites. Benzyloxycarbonyl (Z)-Phe-Arg-CH2F, the most potent inhibitor, inhibited TCP at picomolar concentrations and blocked hemoglobin degradation and killed parasites at nanomolar concentrations. Micromolar concentrations of the inhibitor were nontoxic to cultured mammalian cells. These results support the hypothesis that TCP is a necessary hemoglobinase and suggest that it is a promising chemotherapeutic target.
Africa can solve its own health problems
Authors: D. J Ncayiyana
Journal: BMJ (2002)

See also Papers p 702 

On the evidence of such archaeological finds as Lucy, the australopithecine female unearthed in Ethiopia's Hadar region, Africa is the cradle of the human race. Africa was also home to notable ancient civilisations—the Egypt of the Pharaohs, the Ashanti Empire of the Gold Coast, and the Zimbabwe settlements in the south. Given such a head start, it is ironic that Africa should now find itself at the bottom of the ladder in terms of human development. Most of the countries in sub-Saharan Africa lag far behind other developing nations with respect to critical health indicators such as maternal and infant mortality and life expectancy.

Granted, Africa's legacy of particularly exploitative colonial occupation by European powers is partly to blame. However, Africans themselves must bear the responsibility for failing to create an enabling environment for better health—safe water and sanitation, secure supply of food and nutrition, education, and higher status of women—in the period since the continent's political emancipation that began with Ghana's independence …
Apnoea monitors and accidental strangulation
Authors: J. Meinhardt
Journal: BMJ (1992)

investigate the aetiology.We agree with A FThe authors state that pharmacy based trials referred to, giving optimal and instantaneous Mellon and colleagues about the usefulness of conforming to the European Commission's information.urine microscopy as an aid to diagnosing infection, guidelines for good clinical practice are possible.When these sensors and monitors go to the but we however advise caution when dealing with Compliance with some of the stipulations of the community it is paramount that those who hand children,' patients with a self induced diuresis, and guidelines, however, would be problematic.For them out fully educate the users in their use.These patients with vaginitis or cervicitis.' example, it is necessary to check case record forms moves should prevent further events similar to that Steve Higgins and Eboo Versi preach, wisely, with source documents, such as patients' notes.' reported by Emery and colleagues.that patients should have other causes of urethral This ensures that the record form accurately JASPERIEN MEINHARDT symptoms investigated, and we do not disagree.represents the facts.Unless pharmacists keep Graseby Medical, We, however, took a pragmatic approach, realising separate notes on individual patients such valida-Watford, that this was probably a low risk population' and tion would be impossible.Hertfordshire WD2 4LG that a sexual history could be used as a screeningThe guidelines state that the investigator is IEmrJLTalrM,CpetrRWieA.pna
Living with Parkinson's Disease
Authors: Edwin W. Salzman
Journal: New England Journal of Medicine (1996)

It has been more than 20 years since I first learned that I had Parkinson's disease. I had complained for about six months of aching discomfort in my right arm, fairly typical of thoracic outlet syndrome, or so I believed. I was a vascular surgeon, operating in a hospital affiliated with Harvard Medical School. For me to have a stiff arm was a nuisance.Wasting no time on the thoracic outlet, my consultant neurologist, gently and not without some sadness, examined me briefly and told me that I had Parkinson's disease. He explained the bare outlines of the disease, bringing . . .
A New Physician Manpower Shortage: Clinical Investigators
Authors: Thomas C. Chalmers
Journal: New England Journal of Medicine (1979)

In the past 30 years there has been an explosion of knowledge about normal biologic functions and disease pathogenesis. Although methods of prevention, diagnosis and treatment have improved, the most meaningful impact of progress on clinical research has been the abysmal ignorance that it has uncovered. Clues are everywhere, but final pathways to an understanding of most disease processes, especially the major chronic ones, continue to elude us.The 30-year point of reference was chosen because it was that long ago that the National Institutes of Health, the Medical Research Council in Great Britain and similar organizations in other countries . . .
Wallstent and Unusual Gastrointestinal Bleeding
Authors: M. Balkan, O. Kozak, I. Arslan, F. Alpasian
Journal: Endoscopy (2002)

The endoprosthesis materials currently in use, with low friction coefficients maintaining biliary passage, are Teflon, polyethylene, polyurethane, and Percuflex catheters. In order to reduce the obstruction and displacement rates, expandable metal stents have been developed and tested in cases of malignant biliary disease [1] [2] [3] [4] [5]. Self-expanding metallic stents create an expansion force that gives them the required diameter after they are placed in the stricture (Figure [1]). This case report emphasizes the need for careful placement of metallic stents in order to avoid the complication of intestinal wall erosion.
Is redo percutaneous mitral balloon valvuloplasty (PMV) indicated in patients with post-PMV mitral restenosis?
Authors: Asad Z Pathan, Nasser A Mahdi, Miltiadis N Leon, Julio Lopez-Cuellar, Hector Simosa, Peter C Block, Lari Harrell, Igor F Palacios
Journal: Journal of the American College of Cardiology (1999)
1025-41 Insulin sensitizers are associated with improved outcomes in diabetic patients undergoing brachytherapy
Authors: John A Kao, Mark Grise, Peter Castarella, Huan Giap, Aniradha Koka, Gerard Huppe, Kathleen Sirkin, Prabhakar Tripuraneni, Paul S Teirstein
Journal: Journal of the American College of Cardiology (2004)
399. Solid Nanobeads Prevents Polycations from Entering the Nuclei and Enhanced Transfection Efficiency
Authors: Wenzhong Li, Nan Ma, Leelee Ong, Alexander Kaminski, Peter Lorenz, Brigitte M. Pützer, Ren-Ke Li, Christof Stamm, Gustav Steinhoff
Journal: Molecular Therapy (2006)

Objective: Employment of polycations for gene delivery to treat human diseases remains in doubt as long as the potential for polycations to adversely interact with host genes exists, which is incurred from entering of polycations into nuclei during gene delivery. In this study, we address this issue by conjugating polymer vector- gene complexes to silica nanobeads (SNB) and evaluated the transfection efficacy of marker and therapeutic genes. Methods: The poly-ethyleneimine vector (PEI)/DNA complexes were conjugated to SNB via a Sulfo-NHS-LC-Biotin linker. Luciferase and LacZ were used as reporter genes and VEGF-165 was used as therapeutic gene. Fluorescent labeling and confocal microscopy were employed to tack the paths of PEI/DNA complexes and SNB/PEI/ DNA complexes from endocytosis to gene expression. Stability of the SNB/PEI/DNA complexes was evaluated by DNase I protection assay. In vitro transfection efficacy of SNB/PEI/DNA was assessed in 4 different cell lines and compared with unconjugated PEI/DNA. In vivo, SNB/PEI/DNA complexes were systematically injected via tail vein of the mouse (n=12). Transfection efficacy of marker and therapeutic genes was assessed in the organs (heart, lung, spleen, kidney and liver) by luciferase assay, immunostaining and Western blotting. Results/Discussion: The SNB/PEI/DNA complexes were very stable and could provide more effective protection to DNA from nuclease degradation than PEI/DNA complexes. Confocal microscopy showed that PEI/DNA complexes entered nuclei in the form of ordered structures. In contrast, SNB/PEI/DNA complexes released DNA into the nuclei while SNB kept the PEI perinuclei of the cells. In vitro, 10- to 50-fold higher transfection efficiency for SNB/PEI/DNA complexes was observed compared with PEI/DNA complexes alone. In vivo, systematically injected SNB/PEI/DNA complexes resulted in effective over expression of marker and therapeutic genes. Conclusions: Conjugating polycation vector-gene complexes to solid nanobeads enhanced transfection efficiency and inhibited polymer to enter the nuclei, which may offer a novel way to prevent the risk of interference of polymer with native host DNA.
Absorption of water and sodium and activity of adenosine triphosphatases in the rectal mucosa in tropical sprue.
Authors: B S Ramakrishna, V I Mathan
Journal: Gut (1988)

In 10 southern Indian patients with tropical sprue, in vivo dialysis showed a defect of absorption of water and sodium from the rectum, when compared with 11 healthy volunteers. Sodium-potassium-ATPase activity, measured in homogenates of rectal biopsies, was significantly diminished in patients with sprue. Magnesium-ATPase and alkaline phosphatase were normal in biopsy homogenates. Decreased activity of colonic sodium-potassium-ATPase may contribute to diarrhoea in some patients with tropical sprue.
Sister Mary Joseph's Nodule
Authors: Edythe A Albano, Julie Kanter
Journal: New England Journal of Medicine (2005)

A 12-year-old girl presented with a one-month history of decreased appetite, vomiting, and weight loss. The patient had had no fevers or night sweats. Physical examination revealed a distended abdomen with a fluid wave, a palpable pelvic mass, and a tumor protruding through the umbilicus (Panel A). Computed tomographic scanning showed a large pelvic mass probably originating from the ovary, omental and hepatic metastases, ascites, and a mass through the umbilicus (Panel B). Pathological evaluation of a biopsy specimen showed a desmoplastic small round-cell tumor. The patient received vincristine, doxorubicin, and cyclophosphamide alternating with etoposide and ifosfamide. After two courses . . .
S31 Energy expenditure and physical activity levels during an 8-week pulmonary rehabilitation programme
Authors: J. L. Canavan, K. A. Ingram, R. P. Fowler, A. L. Clark, P. Marns, M. S. Patel, S. S. Kon, W. D-C Man
Journal: Thorax (2011)

<h3>Introduction</h3> The IMPRESS standards for pulmonary rehabilitation (PR) recommend that programmes should include two supervised exercise sessions per week for at least 4 weeks, and written prescriptions of exercise training with evidence of progress reported in training diaries. However, subjective self-reported assessment is associated with bias, and may not accurately represent actual exercise intensity and duration. Patients require familiarisation with equipment and training regimes during a PR programme. We hypothesised that active energy expenditure and time spent in at least moderate physical activity, measured objectively with a validated activity monitor (SenseWear armband—SWA), would show no significant increase within the first 4 weeks of a PR programme. <h3>Method</h3> 34 COPD patients (17M: 17F), starting an 8-week outpatient PR programme consisting of two supervised exercise sessions per week, consented to wearing SWA for one entire exercise training session each week for the whole PR programme (T1–T8). Output from the SWA includes active energy expenditure (AEE) and time spent in at least moderate intensity physical activity (PA time) that is, &gt;3.0 METS. AEE and PA time recorded at T1, T4 and T8 were evaluated using Friedman tests. Incremental shuttle walk (ISW) and COPD Assessment Test (CAT) were measured before (T0) and after (T9) PR. Differences in pre to post-outcome measures were assessed using paired t tests. <h3>Results</h3> Results are presented as median (25th, 75th percentile). There was no significant difference in PA time or AEE between T1 (11.5 (4.0 to 27.0) min; 43.5 (19.5 to 124.3) Kcal) and T4 (10.5 (7.5 to 24.8); 48.5 (32.3 to 106.0) Kcal, p&gt;0.05) despite progress documented in training diaries. PA time significantly increased from T1 to T8 (19.5 (8.8 to 34.0) min, p=0.02), as did AEE (92.0 (37.0 to 146.3) Kcal, p=0.006). Following PR there was also a significant improvement in ISW (52.1 (95% CI 29.2 to 75.1) m, p&lt;0.001) and CAT score (−3.0 (95% CI 0.3 to 5.8) p=0.03). <h3>Conclusion</h3> 4-week PR programmes may be insufficient in duration for patients to become familiarised with equipment and exercise regimes.
Behind the Wall of Respect: Community Experiments in Heroin Addiction Control
Authors: Alan L. Krueger
Journal: JAMA (1978)

Dr Hughes' book is an eloquent argument for an epidemiologic and social approach to the problems of heroin addiction. He applies to drug abuse the same technique commonly used by communicable disease centers in identifying and treating cases of venereal disease.  After an introduction reviewing the epidemiologic approach to the identification, treatment, and subsequent prevention of heroin addiction, the author describes the various community experiments in heroin addiction control that he and his staff carried out in Chicago between 1968 and 1974. Dr Hughes' successful use of former addicts in his field teams, his well-documented studies to identify target populations of heroin addicts, his subsequent methods of involving the heroin abuser in treatment, and his sociological methods of prevention are all clearly explained.  The enormous difficulties encountered in this approach are honestly discussed. Community resistance, problems in overcoming the fiscal bureaucracy, difficulties of effecting changes in the life-style of the
LOW BODY MASS INDEX IS ASSOCIATED WITH IN-HOSPITAL ADVERSE EVENTS AND MORTALITY AMONG IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR RECIPIENTS ENROLLED IN THE NCDR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR REGISTRY
Authors: Jonathan Hsu, Paul Varosy, Haikun Bao, Yongfei Wang, Jeptha Curtis, Gregory Marcus
Journal: Journal of the American College of Cardiology (2012)