tbuckley/cabot-search huggingface dataset:
Treatment of acute renal failure with artificial kidneys.
Authors: D N Kerr
Journal: BMJ (1979)

Gout affects around 1% of people in the UK, most aged over 45 years.1 The condition, which is five times more common in men than women, usually presents as a painful inflammatory monoarthritis, which can be diagnosed clinically and successfully treated with a high dose of an NSAID. Problems arise when the features are atypical or when high doses of an NSAID are inappropriate. Also, there is no robust evidence to guide when to start prophylactic therapy or what advice to give on lifestyle changes. Here we review current practice and offer advice on managing patients with this increasingly common condition, concentrating on approaches to be taken by the non-specialist.
Rat strain differences in the ectopic osteogenic potential of recombinant human BMP adenoviruses
Authors: Jin Zhong Li, Hongwei Li, Brad Dunford, David Holman, Brian Beres, Debra D. Pittman, Gerald R. Hankins, Gregory A. Helm
Journal: Molecular Therapy (2003)

Different animal strains have different genetic backgrounds that influence their physiological function and pathological process. The differences in genetic background may affect the efficiency of adenoviral infection and target gene expression and further cause different gene therapy results when target genes are delivered with adenoviral vectors. In this study, ectopic bone was not seen in ADCMVBMP4 injection sites, but was formed in ADCMVBMP9 injection sites in all rat strains. The mean volumes of bone induced with ADCMVBMP9 were 0.87 ± 0.2 cm3 in Wistar, 0.26 ± 0.1 cm3 in Long-Evans, 0.34 ± 0.2 cm3 in Sprague-Dawley, 0.44 ± 0.1 cm3 in ACI, 0.66 ± 0.2 cm3 in PVG, and 0.58 ± 0.1 cm3 in Fischer344 rats. This indicates that ADCMVBMP9 has different bone formation potentials in different immunocompetent rat strains (P = 0.02). The basic levels of CD4+ and CD8+ T cells in blood before viral infection and titers of adenoviral neutralizing antibodies 30 days post-viral infection were significantly different among rat strains (P < 0.01). The efficiencies of target gene expression delivered with adenovirus were also significantly different in primary muscle cell cultures from different rat strains (P < 0.01). The different osteogenic potentials of ADCMVBMP9 among rat strains may be, in part, due to the differences in immune factors and target gene expression efficiency in muscle tissue.
Potency of Levothyroxine Products
Authors: Sheldon S. Stoffer
Journal: JAMA (1984)

Recently, the company that manufactures the levothyroxine product that we use most often in our practice switched to high-pressure liquid chromotography (HPLC) to monitor their product. As a result, the brand name product now contains 100% of expected potency as determined in our laboratory by radioimmunoassay. Previous studies in our laboratory demonstrated that this product had only 78% of expected potency. This year our patients have a higher mean serum free thyroxine index (FTI) than they have had in the past. In addition, there were more elevated serum FTI levels and fewer elevated serum thyroid-stimulating hormone levels this year. Physicians should be aware of possible product changes being made by manufacturers of levothyroxine products over the next year or so as more companies switch to the HPLC method. The thyroid function studies of patients receiving levothyroxine products should be rather carefully monitored during this transitional period. We suspect that the new products will be more consistent and have a more reliable shelf life.
Leukocytosis due to adrenal metastases from malignant melanoma: Reversal after bilateral adrenalectomy with long‐term survival
Authors: Robert W. Carey, Victoria S. Kunz
Journal: American Journal of Hematology (1988)

Abstract Leukocytosis has been noted in association with many non‐hematologic malignancies in the absence of concurrent infection or metastatic involvement of bone marrow. We report a case of sustained, neutrophilic leukocytosis in a patient with disseminated malignant melanoma which reversed after bilateral adrenalectomy for adrenal metastases.
Statins potentiate the<i>in vitro</i>anti-hepatitis C virus activity of selective hepatitis C virus inhibitors and delay or prevent resistance development
Authors: Leen Delang, Jan Paeshuyse, Inge Vliegen, Pieter Leyssen, Susan Obeid, David Durantel, Fabien Zoulim, Anne Op de Beeck, Johan Neyts
Journal: Hepatology (2009)

Abstract Statins are 3-hydroxyl-3-methylglutaryl coenzyme A (HMG CoA) reductase inhibitors used for the treatment of hypercholesterolemia. It was recently reported that statins inhibit in vitro hepatitis C virus (HCV) RNA replication. We here report that, of five statins studied, mevastatin and simvastatin exhibit the strongest in vitro anti-HCV activity, lovastatin and fluvastatin have moderate inhibitory effects, and pravastatin is devoid of an antiviral effect. A combination of statins with interferon-alpha (IFN-α) or HCV nonstructural (NS)5B polymerase or NS3 protease inhibitors results in an additive antiviral activity in short-term (3 days) antiviral assays. Neither statins, at a concentration of five-fold their median effective concentration (EC 50 ) value, nor polymerase, protease inhibitors, or IFN-α, at concentrations 10- or 20-fold their EC 50 value, were able to clear cells from their replicon following four or six consecutive passages of antiviral pressure. However, the combination of HCV polymerase or protease inhibitors with mevastatin or simvastatin resulted in an efficient clearance of the cultures from their replicon. In colony formation experiments, mevastatin reduced the frequency or prevented the selection of HCV replicons resistant to the nonnucleoside inhibitor HCV-796. Conclusion: A combination of specific HCV inhibitors with statins may result in a more profound antiviral effect and may delay or prevent the development of resistance to such inhibitors. (Hepatology 2009.)
TANNIC ACID TREATMENT OF BURNS
Authors: George H. Weaver
Journal: JAMA (1934)

To the Editor:—  InThe Journal, November 17, page 1556, Dr. J. A. Hagemann refers to a suggestion regarding the use of tannic acid in burns made in 1890. In discussions of the use of tannic acid in the treatment of burns, it is usual to credit its use to a comparatively recent recommendation. An early publication which advocated its use seems to have been overlooked.  In April 1871, Dr. W. H. Searles of Warsaw, Wis., published a short article entitled Tea-Leaves as an Application to Burns and Scalds. The article appeared in the Chicago Medical Examiner , April 1871, page 207. This was the journal edited by Dr. N. S. Davis Sr. As the article is brief, it may be quoted entire:  Some few years since I accidentally found that a poultice of tea-leaves, applied to burns and scalds, afforded immediate relief, and I determined to give it a more
Acupuncture and US Medicine
Authors: Teruo Matsumoto
Journal: JAMA (1972)

Recent reports from the Peoples Republic of China on the value of acupuncture, as well as the lack of information on its scientific foundation, have given the public and the medical profession the impression that acupuncture is rather empirical and that one may, not unjustly, treat it with skepticism. Accordingly, I have reviewed the abundant original descriptions of acupuncture written in foreign languages and undertaken a trip to Japan, where many patients who have received acupuncture treatment have experienced relief from the pain of some illnesses. To understand acupuncture one begins by learning about meridian points, certain points on the body surface that correspond specifically to the particular diseased organ. These points have been discovered by actual experience of more than 3,000 years with the use of acupuncture needles. The needles used in acupuncture come in varying sizes, some as thin as 0.14 mm in diameter. The procedure is considered
Psychological Responses of Obese Type II Diabetic Subjects to Very-Low-Calorie Diet
Authors: Rena R Wing, Marsha D Marcus, Elaine H Blair, Lisa R Burton
Journal: Diabetes Care (1991)

Objective Very-low-calorie diets have been shown to produce dramatic improvements in glycemic control in obese subjects with non-insulin-dependent (type II) diabetes. There have been no studies of the psychological responses of diabetic subjects to these diets. Research Design and Methods This study examined changes in hunger, depression, and anxiety in 33 obese type II diabetic subjects who were randomly assigned to behavior modification programs that used either a balanced diet of 4185–6277 J∕day (1000–1500 cal∕day) throughout or included an 8-wk period of a very-low-calorie diet (1674 J∕day or 400 cal∕day of lean meat, fish, or fowl). Subjects completed the Beck Depression Inventory, the Spielberger State Anxiety Questionnaire, and self-report measures of hunger frequently throughout the 20-wk program. Results Both groups experienced significant improvements in depressive symptomatology, anxiety, and lessening of hunger during the course of the program, with no significant differences observed between the balanced diet and the very-low-calorie diet groups. Conclusions Very-low-calorie diets, used in the context of a behavioral weight-control program, result in reductions in hunger and improvements in mood state comparable to those observed on more moderate weight-loss regimens.
A Randomized, Double-Blind, Placebo-Controlled Study of Risperidone Maintenance Treatment in Children and Adolescents With Disruptive Behavior Disorders
Authors: Magali Reyes, Jan Buitelaar, Paz Toren, Ilse Augustyns, Marielle Eerdekens
Journal: American Journal of Psychiatry (2006)

OBJECTIVE: The authors compared the effects of maintenance versus withdrawal of risperidone treatment in children and adolescents with symptoms of disruptive behavior disorder. METHOD: Patients with disruptive behavior disorder (5–17 years of age and a range of intellect) who had responded to risperidone treatment over 12 weeks were randomly assigned to 6 months of double-blind treatment with either risperidone or placebo. The primary efficacy measure was time to symptom recurrence, defined as sustained deterioration on either the Clinical Global Impression severity rating (÷2 points) or the conduct problem subscale of the Nisonger Child Behavior Rating Form (÷7 points). Secondary efficacy measures included rates of discontinuation due to symptom recurrence, disruptive behavior disorder symptoms, and general function. Safety and tolerability were also assessed. Risperidone dosage was based on weight (patients <50 kg: 0.25–0.75 mg/day; patients ÷50 kg: 0.5–1.5 mg/day). RESULTS: Treatment was initiated in 527 patients, with 335 randomly assigned to a double-blind maintenance condition. Time to symptom recurrence was significantly longer in patients who continued risperidone treatment than in those switched to placebo. Symptom recurrence in 25% of patients occurred after 119 days with risperidone and 37 days with placebo. Secondary efficacy measures also favored risperidone over placebo. Weight increased over the initial 12 weeks of treatment (mean weight z score change=0.2, SD=2.7, N=511), after which it plateaued. CONCLUSIONS: This study is the first placebo-controlled maintenance versus withdrawal trial of its kind in disruptive behavior disorder and provides evidence that patients who respond to initial treatment with risperidone would benefit from continuous treatment over the longer term.
Mortality and Morbidity of Aortic Regurgitation in Clinical Practice
Authors: Karl S. Dujardin, Maurice Enriquez-Sarano, Hartzell V. Schaff, Kent R. Bailey, James B. Seward, A. Jamil Tajik
Journal: Circulation (1999)

The outcome of aortic regurgitation conservatively followed in clinical practice is poorly defined.Long-term outcome of 246 patients with severe or moderately severe aortic regurgitation diagnosed by color Doppler echocardiography was analyzed. With conservative management, mortality rate was higher than expected (at 10 years, 34+/-5%, P<0. 001) and morbidity was high (10-year rates of 47+/-6% for heart failure and 62+/-4% for aortic valve surgery). At 10 years, 75+/-3% of patients had died or had surgery and 83+/-3% had had cardiovascular events. In multivariate analysis, predictors of survival were age (P<0.001), functional class (P<0.001), comorbidity index (P=0.033), atrial fibrillation (P=0.002), and left ventricular end-systolic diameter corrected for body surface area (P=0.025). Ejection fraction was also an independent predictor of overall survival, including postoperative follow-up of surgically treated patients (P<0.001). High risk during conservative treatment, with mortality rate in excess of that expected, was noted among patients with severe, even transient, symptoms (24.6% yearly, P<0.001) but also in those with mild (class II) symptoms (6.3% yearly, P=0.02) and in asymptomatic patients with left ventricular ejection fraction <55% (5.8% yearly, P=0.03) or with end-systolic diameter normalized to body surface area >/=25 mm/m2 (7.8% yearly, P=0.004). Surgery performed during follow-up was independently associated with reduced cardiovascular mortality (adjusted hazard ratio, 0.54; P=0.048).Patients diagnosed with severe aortic regurgitation in clinical practice incur excess mortality and high morbidity, underscoring the serious prognosis of the disease. Surgery, which reduces cardiac mortality rates, should be considered promptly in high-risk patients.
Ultrasound Modulates the Splenic Neuroimmune Axis in Attenuating AKI
Authors: Joseph C. Gigliotti, Liping Huang, Amandeep Bajwa, Hong Ye, Eric H. Mace, John A. Hossack, Kambiz Kalantari, Tsuyoshi Inoue, Diane L. Rosin, Mark D. Okusa
Journal: Journal of the American Society of Nephrology (2015)

We showed previously that prior exposure to a modified ultrasound regimen prevents kidney ischemia-reperfusion injury (IRI) likely via the splenic cholinergic anti-inflammatory pathway (CAP) and α7 nicotinic acetylcholine receptors (α7nAChR). However, it is unclear how ultrasound stimulates the splenic CAP. Further investigating the role of the spleen in ischemic injury, we found that prior splenectomy (-7d) or chemical sympathectomy of the spleen with 6-hydroxydopamine (6OHDA; -14d) exacerbated injury after subthreshold (24-minute ischemia) IRI. 6-OHDA-induced splenic denervation also prevented ultrasound-induced protection of kidneys from moderate (26-minute ischemia) IRI. Ultrasound-induced protection required hematopoietic but not parenchymal α7nAChRs, as shown by experiments in bone marrow chimeras generated with wild-type and α7nAChR(-/-) mice. Ultrasound protection was associated with reduced expression of circulating and kidney-derived cytokines. However, splenocytes isolated from mice 24 hours after ultrasound treatment released more IL-6 ex vivo in response to LPS than splenocytes from sham mice. Adoptive transfer of splenocytes from ultrasound-treated (but not sham) mice to naïve mice was sufficient to protect kidneys of recipient mice from IRI. Ultrasound treatment 24 hours before cecal ligation puncture-induced sepsis was effective in reducing plasma creatinine in this model of AKI. Thus, splenocytes of ultrasound-treated mice are capable of modulating IRI in vivo, supporting our ongoing hypothesis that a modified ultrasound regimen has therapeutic potential for AKI and other inflammatory conditions.
Increased Intratumoral FOXP3-positive Regulatory Immune Cells during Interleukin-2 Treatment in Metastatic Renal Cell Carcinoma
Authors: Hanne Krogh Jensen, Frede Donskov, Marianne Nordsmark, Niels Marcussen, Hans von der Maase
Journal: Clinical Cancer Research (2009)

The administration of interleukin-2 (IL-2) may increase the frequency of peripherally circulating FOXP3-positive regulatory immune cells, thus potentially compromising this treatment option for patients with metastatic renal cell carcinoma. The impact of IL-2-based therapy on the accumulation of FOXP3-positive immune cells in the tumor microenvironment in metastatic renal cell carcinoma is unknown.Baseline (n = 58) and on-treatment (n = 42) tumor core biopsies were prospectively obtained from patients with clear cell metastatic renal cell carcinoma before and during IL-2-based immunotherapy. Immunohistochemical expression of FOXP3 was estimated by stereological counting technique and correlated with other immune cell subsets and overall survival.A significant increase in absolute intratumoral FOXP3-positive immune cells was observed comparing baseline (median 23 cells/mm2; range, 0-183) and on-treatment biopsies (median, 89 cells/mm2; range, 11-388; P < 0.001). The relative increase in individual patients was median 4.7-fold, range 0.3 to 230. FOXP3-positive cells were positively correlated with CD3-positive, CD4-positive, and CD8-positive tumor-infiltrating immune cells at baseline and during treatment (P < 0.05 in all comparisons). All patients achieving high numbers (>180 cells/mm2) of on-treatment FOXP3-positive intratumoral immune cells were dead within 22 months (n = 11), whereas patients with low numbers (<180 cells/mm2) of on-treatment FOXP3-positive cells (n = 31) had a 5-year survival rate of 19% (hazard ratio, 2.2; confidence interval, 1.03-4.5; P = 0.043). All long-term survivors were characterized by low-baseline FOXP3-positive cells and a modest absolute rise in FOXP3-positive cells.Intratumoral FOXP3-positive regulatory immune cells significantly increased during IL-2-based immunotherapy, and high numbers of on-treatment FOXP3-positive cells were correlated with poor prognosis in patients with metastatic renal cell carcinoma.
Increasing fibrillation duration enhances relative asymmetrical biphasic versus monophasic defibrillator waveform efficacy.
Authors: J L Jones, J F Swartz, R E Jones, R Fletcher
Journal: Circulation Research (1990)

Biphasic waveforms reduce defibrillation threshold compared with corresponding monophasic waveforms. However, effects of fibrillation duration on relative efficacy of monophasic and biphasic waveforms are unknown. This study used a newly developed defibrillation model, the isolated right- and left-sided working rabbit heart, with epicardial defibrillation electrodes, to compare threshold for a monophasic waveform (5 msec rectangular) and an asymmetrical biphasic waveform (5 msec each pulse, V2 = 50% V1). Mean voltage defibrillation threshold (V50) was determined from sigmoidal probability of successful defibrillation versus shock intensity curves after 5, 15, and 30 seconds of fibrillation in a paired study with 10 hearts. Results showed that biphasic waveforms had significantly lower voltage and energy thresholds at all fibrillation durations and that their relative efficacy improved with increasing fibrillation duration. Biphasic voltage threshold was 38.2 +/- 2.2, 44.7 +/- 4.8, and 46.6 +/- 3.2 V after 5, 15, and 30 seconds of fibrillation compared with monophasic thresholds of 51.7 +/- 4.4 (p less than 0.002), 63.0 +/- 7.6 (p less than 0.05), and 72.1 +/- 3.9 V (p less than 0.005). Biphasic waveform energy threshold was 0.67 that for the monophasic waveform after 5 seconds of fibrillation (0.12 +/- 0.01 versus 0.18 +/- 0.03 J, p less than 0.05). The ratio between biphasic waveform threshold and monophasic waveform threshold (B/M) decreased to 0.62 at 15 seconds. At 30 seconds, B/M was 0.52 (0.17 +/- 0.02 versus 0.33 +/- 0.04 J, p less than 0.02). This study also showed that biphasic waveform threshold was a nonlinear function of monophasic waveform threshold so that improved biphasic defibrillator waveform efficacy was greatest for hearts having higher monophasic thresholds.(ABSTRACT TRUNCATED AT 250 WORDS)
Enalapril (EN) improves alveolar-capillary diffusion in chronic heart failure (CHF) and aspirin (AS) contrasts this effect
Authors: Marco Guazzi, Pier G. Agostoni, Gian C. Marenzi, Gian F. Lauri, Emilio Assanelli, Maurizio D. Guazzi
Journal: Journal of the American College of Cardiology (1996)
Assessment of the Psychological Factors and Responses in Self-Managed Patients
Authors: Andre Dupuis
Journal: Diabetes Care (1980)

In past studies on the psychological aspects of diabetes mellitus, symptoms of depression have been identified as the most common manifestation among diabetic patients. Other psychological manifestations have been anxiety, hypochondriasis, increased dependence and passivity, and poor self-image. Ten insulin-dependent diabetic patients participated in a rigorous program of self-monitored blood glucose determinations, and their emotional response to the program was studied. They were initially bewildered and tended to resist passively to the demands of the program. With continuous experimentation and assertive trials, these patients developed better self-reliance, diminished anxiety, and better acceptance of their illness. Psychiatric assessments performed at the beginning of the study and after 8 mo revealed that all patients were depressed at the beginning of the study as reflected by high scores in the Hamilton Rating Scale. After 8 mo, all 10 patients had achieved better carbohydrate control, as reflected by decreased hemoglobin A1c levels, and were found to be much less depressed.
Prediction of Cardiac Events in Patients With Reduced Left Ventricular Ejection Fraction With Dobutamine Cardiovascular Magnetic Resonance Assessment of Wall Motion Score Index
Authors: Erica Dall'Armellina, Timothy M. Morgan, Sangeeta Mandapaka, William Ntim, J. Jeffrey Carr, Craig A. Hamilton, John Hoyle, Hollins Clark, Paige Clark, Kerry M. Link, Doug Case, W. Gregory Hundley
Journal: Journal of the American College of Cardiology (2008)
Comment: Carcinoma of the Anus
Authors: Philip Rubin
Journal: JAMA (1975)

FORTUNATELY, tumors of the anus are uncommon; they constitute less than 5% of rectal carcinomas. The major sex differentiation is that the lesions are more likely to arise on the anal verge in men, and in the anal canal in women. The age range for peak incidence is from the fourth to sixth decades. This tumor is often mistaken for a benign lesion since pruritus is the most common symptom; an association with hemorrhoids, fissures, leukoplakia, or condyloma is not unusual. Even rectal bleeding may be attributed to accompanying and more common benign states. It is only with complaints of tenesmus resulting from a mass, recurring pain in the perineum, or repeated rectal hemorrhages that the patient becomes concerned and seeks medical attention. Incontinence and stricture are late findings; the former suggests deep invasion into muscle, rendering the sphincteric control incompetent; stricture decreases stool caliber. Lymphogranuloma venereum should be added
Points from Letters: Transvaginal Pudendal Block
Authors: J. U. Watson
Journal: BMJ (1965)

The entrant's share is low while he absorbs the intricacies of an established practice, theoretically leaning heavily for advice, etc., on his senior.How often does this work out ?Is the long and slow climb to parity necessary ?The prolonged discrepancies between share and work load all too commonly cause bad feeling and bitterness.Finally, is it not sad that any young man, proud of his heritage, product of a Scottish medical school, deems it necessary to leave his parents, friends, and familiar way of life and travel thousands of miles in the hope of making things better for himself and his family to a country of which, apart from the little he has learned from letters and journals, he knows nothing at all ?-I am, etc.,
Danger of using an unreliable classification system for preschool wheeze
Authors: A. Schultz, D. Payne
Journal: European Respiratory Journal (2009)

discrepancy in TB incidence rates reported in Norway by HEIMBECK [4] in 1928 and reviewed elsewhere [5].Additional support for this ''threshold effect'' is provided by differences in the calculated annual risk of infection observed in two adjacent study communities, where socioeconomic conditions in the area with reduced transmission are sufficiently improved to affect general living conditions [6].