tbuckley/cabot-search huggingface dataset:
Efficacy of peginterferon alpha-2b in chronic hepatitis delta: Relevance of quantitative RT-PCR for follow-up
Authors: Corinne Castelnau, Frédéric Le Gal, Marie-Pierre Ripault, Emmanuel Gordien, Michelle Martinot-Peignoux, Nathalie Boyer, Bach-Nga Pham, Sarah Maylin, Pierre Bedossa, Paul Dény, Patrick Marcellin, Elyanne Gault
Journal: Hepatology (2006)

Hepatitis delta virus (HDV) can cause severe acute and chronic liver disease in patients infected by hepatitis B virus. Interferon alpha at high doses, although poorly efficient, is the only treatment reported to provide some benefit in chronic hepatitis delta. Pegylated interferon alpha (PEG-IFN) has not yet been evaluated. Treatment is usually monitored by the qualitative detection of HDV-RNA in serum. In this study, safety and efficacy of PEG-IFN were assessed in chronic hepatitis delta, and serum HDV-RNA kinetics were determined using quantitative RT-PCR. Fourteen patients with chronic hepatitis delta received subcutaneous PEG-IFN alpha-2b during 12 months (1.5 microg/kg per week). Serum HDV-RNA was quantified at initiation and during the course of therapy, and during the posttreatment follow-up period, which ranged from 6 to 42 months (median 16 months). PEG-IFN alpha-2b was well tolerated, inducing no serious adverse effect. Sustained biochemical response was obtained in 8 patients (57%). At the end of treatment, 8 patients (57%) had achieved virological response (undetectable HDV-RNA). Sustained virological response throughout the posttreatment follow-up period was observed in 6 patients (43%). HDV-RNA kinetics were predictive of the response: after 3 months of PEG-IFN, HDV-RNA levels were significantly lower in the responders than in the nonresponders group (P=.018). After 6 months of therapy, a negative HDV-RNA was predictive of sustained response (P=.021). In conclusion, this preliminary study indicates that PEG-IFN alpha-2b is safe and efficient for treatment of chronic hepatitis delta. The follow-up of HDV-RNA levels during therapy, which allows the differentiation of various profiles of virological responses, improves treatment monitoring.
Treatment of Air Embolism
Authors: Jacob Fine
Journal: JAMA (1979)

To the Editor.—  A letter on air embolism inThe Journal(240:1713, 1978) is informative on the pressure gradients that produce it. However, like other previous letters I have encountered on this subject in this and other journals, little or nothing is said on how to deal with the disorder once it is recognized. In the mid-1930s, I, along with several collaborators, published a series of articles stressing the principle that the inhalation of pure oxygen rapidly reduces the partial pressure of nitrogen in the blood as well as in the alveoli, and so allows the nitrogen in the embolized air to be exhaled. 1-5   This principle, which, I gather, continues to be ignored, was used not only for air embolism, but also to relieve tension in mediastinal or subcutaneous emphysema, in the cerebral ventricles following ventriculography, and for severe gaseous distension of the intestine as well as for air
Long term outcomes of sacral nerve stimulation for faecal incontinence
Authors: A. George, R. J. Nicholls, C. J. Vaizey
Journal: Gut (2011)

<h3>Introduction</h3> In patients with faecal incontinence (FI) who fail to benefit from medical or behavioural treatments sacral nerve stimulation (SNS) is now considered a first-line procedure.1 While the efficacy of treatment appears to be sustained in the short and medium term,2 the long-term results of therapy are relatively unknown. We present the 10 year follow-up results of SNS for faecal incontinence performed at a single centre. We present the 10 year follow-up results of SNS for faecal incontinence performed at a single centre. <h3>Methods</h3> All patients who underwent SNS for faecal incontinence from 1996 to 2002 were followed prospectively. Data was collected prospectively using bowel habit diaries and St Mark9s continence scores. Treatment success was defined as &gt; 50% reduction in episodes of faecal incontinence with SNS when compared to baseline symptoms. <h3>Results</h3> Between January 1996 and December 2002, 25 patients (M:F 2:23) (mean age 51 years (10.2)) underwent temporary SNS. Twenty four (96%) patients had a greater than 50% improvement in their ability to defer defecation during the trial phase and were considered suitable for chronic stimulation. Over a median follow-up of 108 months (range 88–150 months) the efficacy of neurostimulation was maintained in 21 of the 24 patients implanted as reflected in the St Mark9s scores, ability to defer defecation and incontinence episodes per 2 weeks. Two patients (8%) lost efficacy at 48 and 60 months post permanent implant due to unknown reasons and had the device removed. One patient died at 36 months post permanent implant due to an unrelated event. Seven patients required change of battery at a mean of 72 months (SD 3.4). There were no further complications. <h3>Conclusion</h3> SNS can produce a sustained improvement in symptoms for up to 10 years in majority of patients implanted. Some patients will experience deterioration in their symptoms over time, for reasons yet unknown.
The Prevalence of Cardiac Valvular Insufficiency Assessed by Transthoracic Echocardiography in Obese Patients Treated with Appetite-Suppressant Drugs
Authors: Mehmood A. Khan, Charles A. Herzog, John V. St. Peter, Guilford G. Hartley, Richard Madlon-Kay, Candace D. Dick, Richard W. Asinger, John T. Vessey
Journal: New England Journal of Medicine (1998)

After case reports of cardiac-valve abnormalities related to the use of appetite suppressants were published, we undertook a study to determine the prevalence of the problem using transthoracic echocardiography.We examined patients who had taken dexfenfluramine alone, dexfenfluramine and phentermine, or fenfluramine and phentermine for various periods. We enrolled obese patients who had taken or were taking these agents during open-label trials from January 1994 through August 1997. We also recruited subjects who had not taken appetite suppressants and who were matched to the patients for sex, height, and pretreatment age and body-mass index. The presence of cardiac-valve abnormalities, defined by the Food and Drug Administration and Centers for Disease Control and Prevention as at least mild aortic-valve or moderate mitral-valve insufficiency, was determined independently by at least two cardiologists. Multivariate logistic-regression analysis was used to identify factors associated with cardiac-valve abnormalities.Echocardiograms were available for 257 patients and 239 control subjects. The association between the use of any appetite suppressant and cardiac-valve abnormalities was analyzed in a final matched group of 233 pairs of patients and controls. A total of 1.3 percent of the controls (3 of 233) and 22.7 percent of the patients (53 of 233) met the case definition for cardiac-valve abnormalities (odds ratio, 22.6; 95 percent confidence interval, 7.1 to 114.2; P<0.001). The odds ratio for such cardiac-valve abnormalities was 12.7 (95 percent confidence interval, 2.9 to 56.4) with the use of dexfenfluramine alone, 24.5 (5.9 to 102.2) with the use of dexfenfluramine and phentermine, and 26.3 (7.9 to 87.1) with the use of fenfluramine and phentermine.Obese patients who took fenfluramine and phentermine, dexfenfluramine alone, or dexfenfluramine and phentermine had a significantly higher prevalence of cardiac valvular insufficiency than a matched group of control subjects.
Diuretic Therapy for Malignant Effusion
Authors: John B. Weeth
Journal: JAMA (1962)

RETENTION of fluid is often a most troublesome symptom of patients with cancer. Relieving the patient of abnormal collections of fluid makes him more comfortable and frequently enables him to resume his normal daily routine. We should like to review briefly the available therapy of this problem, emphasizing the beneficial results of oral administration of diuretic agents, particularly the thiazide diuretics and an aldosterone antagonist (spironolactone). Successful antineoplastic chemotherapy is an effective answer to malignant effusion. If the malignant process cannot be controlled, local antineoplastic therapy may still be of benefit. Injection of oncolytic chemotherapeutic agents into the pleural or peritoneal space, after withdrawal of as much of the fluid as possible, can be an efficient longterm method of controlling effusion due to malignant tumors. Nitrogen mustard, 0.2 to 0.6 mg. per kilogram of body weight, is widely used for this purpose. Radioactive isotopes have also successfully controlled certain types
Comparison of resection, liver transplantation and transcatheter oily chemoembolization in treatment of hepatocellular carcinoma
Authors: Jean-Pierre Bronowicki, Karim Boudjema, Laurence Chone, Gabriel Nisand, Christophe Bazin, Francis Pflumio, Georges Uhl, Jean-Jacques Wenger, Daniel Jaeck, Patrick Boissel, Marc André Bigard, Pierre Gaucher, Denis Vetter, Michel Doffoel
Journal: Journal of Hepatology (1996)
Hypertrophic cardiomyopathy: Authors' reply
Authors: Paolo Spirito, Camillo Autore
Journal: BMJ (2006)

EDITOR—Wald and Law assert that coronary artery disease, rather than hypertrophic cardiomyopathy, is the most common cause of sudden and unexpected cardiac death in the young. Our differing conclusions were based on the recent guidelines on hypertrophic cardiomyopathy and on the results of a large and systematic evaluation of the causes of sudden death in competitive athletes.1 …
Comparative reproducibility and validity of systems for assessing cardiovascular functional class: advantages of a new specific activity scale.
Authors: L Goldman, B Hashimoto, E F Cook, A Loscalzo
Journal: Circulation (1981)

Reproducibility and validity are prerequisites for a useful clinical scale. We therefore prospectively tested the reproducibility and validity of the New York Heart Association criteria and the Canadian Cardiovascular Society criteria for the assessment of cardiac functional class and compared these criteria with a new Specific Activity Scale based on the metabolic costs of specific activities. The New York Heart Association estimates made by two physicians had a reproducibility of only 56%, and only 51% of the estimates agreed with treadmill exercise performance. Functional estimates based on the Canadian Cardiovascular Society criteria were significantly more reproducible (73%), but not significantly more valid. The Specific Activity Scale was as reproducible as the Canadian Cardiovascular Society criteria, and its 68% validity was significantly higher than the validities of the other systems. The easily administered Specific Activity Scale was equally reproducible and valid when used by a nonphysician. It was especially better than the other systems for the evaluation of true class II patients and was significantly less likely to underestimate treadmill performance. Although no set of questions can perfectly predict exercise tolerance, the Specific Activity Scale deserves wider prospective testing.
Human b-cell differentiation. I. Analysis of immunoglobulin heavy chain switching using monoclonal anti-immunoglobulin M, G, and A antibodies and pokeweed mitogen-induced plasma cell differentiation.
Authors: T Kuritani, M D Cooper
Journal: The Journal of Experimental Medicine (1982)

Monoclonal antibodies were used to examine the immunoglobulin isotypes expressed by B lymphocyte precursors of IgM, IgG, IgA, and IgA2 plasma cells. Plasma-cell differentiation was induced by the addition of pokeweed mitogen to cultures of blood mononuclear cells. Anti-mu, -gamma, -alpha, and -alpha 1 antibodies were used in some experiments to inhibit differentiation of B lymphocytes bearing these heavy chain isotypes, and for selective removal of B lymphocyte precursors before culture with pokeweed mitogen in other experiments. Three major subpopulations of B lymphocyte precursors were identified: (a) a subpopulation of surface (s) IgM+ precursors of IgM plasma cells that did not express IgG or IgA isotypes, (b) a subpopulation of sIgG+ precursors of IgG plasma cells of which approximately one-half bore some IgM and none had detectable IgA receptors, and (c) a subpopulation of sIgA+ precursors of IgA plasma cells; one half of these precursors could be shown to express functional IgM receptors but none were found to express IgG receptors. The sIgA subpopulation could be further subdivided into sIgA1+ precursors of IgA1 plasma cells and IgA1-negative precursors of IgA2 plasma cells. These results suggest that normal human B cells can switch from mu directly to each of the other heavy chain isotypes, and that these represent the main switch pathways.
Response to Prasugrel and Levels of Circulating Reticulated Platelets in Patients With ST-Segment Elevation Myocardial Infarction
Authors: Leor Perl, Hila Lerman-Shivek, Eldad Rechavia, Muthiah Vaduganathan, Dorit Leshem-Lev, Noa Zemer-Wassercug, Oshrat Dadush, Pablo Codner, Tamir Bental, Alexander Battler, Ran Kornowski, Eli I. Lev
Journal: Journal of the American College of Cardiology (2013)
Focal Bone Pain
Authors: Letty G. Lutzker
Journal: JAMA (1976)

A LIMPING child complains of pain in a lower extremity, is febrile, and has localized soft tissue swelling and tenderness to deep palpation over the bone. Laboratory studies disclose a normal or slightly elevated white blood cell (WBC) count and an elevated erythrocyte sedimentation rate (ESR). Results of a roentgenographic examination demonstrate no pathologic findings. This is a relatively common presentation in a pediatric emergency room. Does the child have osteomyelitis? Cellulitis? Bone infarct? Although blood cultures will be done, it is not desirable to delay therapy of bone infection while waiting for the results. Roentgenographic studies are not helpful since they may not show positive findings for a week or more. The following cases illustrate the usefulness of radionuclide bone imaging in situations of this type. <h3>Report of Cases</h3><h3>Case 1.—</h3> A 10-year-old boy had a limp and a swollen, hot, tender, painful left ankle of four days' duration
Diagnosis of IgG4-Related Tubulointerstitial Nephritis
Authors: Yassaman Raissian, Samih H. Nasr, Christopher P. Larsen, Robert B. Colvin, Thomas C. Smyrk, Naoki Takahashi, Ami Bhalodia, Aliyah R. Sohani, Lizhi Zhang, Suresh Chari, Sanjeev Sethi, Mary E. Fidler, Lynn D. Cornell
Journal: Journal of the American Society of Nephrology (2011)

IgG4-related systemic disease is an autoimmune disease that was first recognized in the pancreas but also affects other organs. This disease may manifest as tubulointerstitial nephritis (IgG4-TIN), but its clinicopathologic features in the kidney are not well described. Of the 35 patients with IgG4-TIN whose renal tissue specimens we examined, 27 (77%) had acute or progressive chronic renal failure, 29 (83%) had involvement of other organ systems, and 18 of 23 (78%) had radiographic abnormalities. Elevated total IgG or IgG4 serum levels were present in 79%. All pathologic specimens featured plasma cell–rich TIN, with most showing diffuse, expansile interstitial fibrosis. Immune complexes along the tubular basement membranes were present in 25 of 30 (83%). All specimens had a moderate to marked increase in IgG4+ plasma cells by immunohistochemistry. We used a control group of 175 pathologic specimens with plasma cell–rich interstitial infiltrates that can mimic IgG4-TIN to examine the diagnostic utility of IgG4 immunostaining. Excluding pauci-immune necrotizing and crescentic glomerulonephritis, IgG4 immunohistochemistry had a sensitivity of 100% (95% CI 90–100%) and a specificity of 92% (95% CI 86–95%) for IgG4-TIN. Of the 19 patients with renal failure for whom treatment and follow-up data were available, 17 (89%) responded to prednisone. In summary, because no single test definitively diagnoses IgG4-related systemic disease, we rely on a combination of histologic, immunophenotypic, clinical, radiographic, and laboratory features. When the disease manifests in the kidney, our data support diagnostic criteria that can distinguish IgG4-TIN from other types of TIN.
EUS-guided celiac block and neurolysis
Authors: D. Collins, I. Penman, G. Mishra, P. Draganov
Journal: Endoscopy (2006)

Abdominal pain related to pancreatic cancer or chronic pancreatitis can be a disabling and difficult symptom to treat for patients, their families, and physicians. Pharmacologic therapy with nonsteroidal anti-inflammatory drugs is usually ineffective. Opiate analgesics may not be well tolerated and can lead to dependence. Endoscopic ultrasound-guided celiac plexus block offers a potential adjunct treatment for pain control.
Survival of 1,181 Patients in a Phase I Clinic: The MD Anderson Clinical Center for Targeted Therapy Experience
Authors: Jennifer Wheler, Apostolia M. Tsimberidou, David Hong, Aung Naing, Gerald Falchook, Sarina Piha-Paul, Siqing Fu, Stacy Moulder, Bettzy Stephen, Sijin Wen, Razelle Kurzrock
Journal: Clinical Cancer Research (2012)

Abstract Purpose: To determine whether the Royal Marsden Hospital (RMH; London, UK) prognostic score for phase I patients can be validated in a large group of individuals seen in a different center and whether other prognostic variables are also relevant, we present an analysis of 1,181 patients treated in the MD Anderson Cancer Center (MDACC; Houston, TX) phase I clinic. Experimental Design: Medical records of 1,181 consecutive patients who were treated on at least one trial in the phase I clinic were reviewed. Results: The median age was 58 years and 50% were women. The median number of prior therapies was four and median survival 10 months [95% confidence interval (CI), 9.1–10.9 months]. Independent factors that predicted shorter survival in a multivariate Cox model and could be internally validated included RMH score of &amp;gt;1 (P &amp;lt; 0.0001; albumin &amp;lt;3.5 g/dL; lactate dehydrogenase &amp;gt;upper limit of normal, and &amp;gt;two sites of metastases), gastrointestinal tumor type (P &amp;lt; 0.0001), and Eastern Cooperative Oncology Group performance status ≥1 (P = 0.0004). The median survival was 24.0, 15.2, 8.4, 6.2, and 4.1 months for patients with 0, 1, 2, 3, and 4 or 5 of the above risk factors, respectively. Conclusion: The RMH score was validated in a large group of patients at MDACC. Internal validation of the independent prognostic factors for survival led to the development of the MDACC prognostic score, a modification of the RMH score that strengthens it. Clin Cancer Res; 18(10); 2922–9. ©2012 AACR.
Febrile ulceronecrotic Mucha-Habermann disease with clonality: A cutaneous T-cell lymphoma entity?
Authors: Antonio Cozzio, Jürg Hafner, Werner Kempf, Andreas Häffner, Gabriele Palmedo, Sonja Michaelis, Michel Gilliet, Dieter Zimmermann, Günter Burg
Journal: Journal of the American Academy of Dermatology (2004)
Getting the Facts Straight on Health Care Reform
Authors: Jonathan Gruber
Journal: New England Journal of Medicine (2009)

The United States stands on the verge of the most significant change to our health care system since the 1965 introduction of Medicare. The bill that was passed by the House and a parallel bill before the Senate would cover most uninsured Americans, saving thousands of lives each year and putting an end to our status as the only developed country that places so many of its citizens at risk for medical bankruptcy. Moreover, the bills would accomplish this aim while reducing the federal deficit over the next decade and beyond. They would reform insurance markets, lower administrative costs, increase . . .
'Lp(a)' Joins Other Serum Cholesterol Lipoproteins as Risk Determinant
Authors: Beverly Merz
Journal: JAMA (1989)

ANOTHER LIPOPROTEIN has been added to the roster of serum cholesterol components to be reckoned with. According to recent reports, serum concentrations of lipoprotein(a), often referred to as "Lp(a)," may be just as important as those of low-density lipoprotein (LDL) and high-density lipoprotein (HDL) in determining risk for coronary heart disease. At a recent American Heart Association science writers' seminar in Monterey, Calif, John J. Albers, PhD, reported that a study of men with coronary disease indicated that Lp(a) was a better predictor of severity than either LDL or HDL. Albers, who is research professor of medicine and pathology at the University of Washington School of Medicine, Seattle, said that he and colleague B. Greg Brown, MD, found that Lp(a) levels varied directly with degree of arterial stenosis, with 27% of more than 200 patients with extensive three-vessel disease having Lp(a) levels in the 95th percentile (1.25 mm/L or 48
Coronary Heart Failure and Left Ventricular Diastolic Dysfunction
Authors: Jalal K. Ghali
Journal: Annals of Internal Medicine (1993)

Letters1 April 1993Coronary Heart Failure and Left Ventricular Diastolic DysfunctionJalal K. Ghali, MDJalal K. Ghali, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-118-7-199304010-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In their comprehensive review of left ventricular diastolic dysfunction as a cause of heart failure, Bonow and Udelson [1] did not mention clinical features that would enable clinicians to recognize this condition at the bedside. In a recent study of 82 patients admitted for decompensated heart failure [2], we found that the combination of a diastolic blood pressure of 105 mm Hg or more and the absence of jugular venous distention had a specificity and positive predictive value approaching 100%. Recognizing these points should improve the clinician's ability to identify diastolic heart failure at the bedside.References1. Bonow RO, Udelson JE. Left ventricular diastolic dysfunction as a cause of congestive heart failure: mechanisms and management. Ann Intern Med. 1992; 117:502-10. Google Scholar2. Ghali JK, Kadakia S, Cooper RS, Liao Y. Bedside diagnosis of preserved versus impaired left ventricular systolic function in heart failure. Am J Cardiol. 1991; 67:1002-6. Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 April 1993Volume 118, Issue 7Page: 569KeywordsBlood pressureHeart failureLongitudinal studiesPositive predictive valueSpecificity Issue Published: 1 April 1993 CopyrightCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...