tbuckley/cabot-search huggingface dataset:
Flurazepam and Other Benzodiazepines
Authors: THOMAS E. FINUCANE
Journal: Annals of Internal Medicine (1984)

Letters and Corrections1 September 1984Flurazepam and Other BenzodiazepinesTHOMAS E. FINUCANE, M.D.THOMAS E. FINUCANE, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-101-3-403_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Flurazepam (Dalmane; Roche Products, Inc. , Manati, Puerto Rico) "probably has no unique hypnotic properties not shared by other benzodiazepines" (1). It is often substantially more expensive and its long-acting metabolites may reduce performance scores the day after it is administered, as Dr. Berlin notes (2). Yet flurazepam continues to be the most prescribed hypnotic in the United States, by a substantial margin.Berlin (2) may have singled out flurazepam for discussion because it is so commonly prescribed, but I am afraid that by mentioning it so prominently (the first of only three headlined sections on specific...References1. Choice of a benzodiazepine for treatment of anxiety or insomnia. Med Lett Drugs Ther. 1977;19:50. MedlineGoogle Scholar2. BERLIN R. Management of insomnia in hospitalized patients. Ann Intern Med. 1984;100:398-404. LinkGoogle Scholar3. PERRY S and WU A. Rationale for the use of hypnotic agents in a general hospital. Ann Intern Med. 1984;100:441-6. LinkGoogle Scholar4. DEMENT W, MILES L, and CARSKADON M. White paper on sleep and aging. J Am Geriatr Soc. 1982;30:25-50. CrossrefMedlineGoogle Scholar5. Drugs and insomnia. JAMA. 1984;251:2410-4. CrossrefMedlineGoogle Scholar1. BERLIN R, LITOVITZ G, and DIAZ M. Sleep disorders on a psychiatric consultation service. Am J Psychiatry. 1984;141:582-4. CrossrefMedlineGoogle Scholar2. ORR W, STAHL M, DEMENT W, and REDDINGTON D. Physician education in sleep disorders. J Med Ed. 1980;55:367-9. MedlineGoogle Scholar3. BERLIN R. Management of insomnia in hospitalized patients. Ann Intern Med. 1984;100:398-404. LinkGoogle Scholar4. KALES A, BIXLER E, KALES J, and SCHARF M. Comparitive effectiveness of nine hypnotic drugs: sleep laboratory studies. J Clin Pharmacol. 1977;17:207-13. CrossrefMedlineGoogle Scholar5. GREENBLATT D and SHADER R. The clinical choice of sedative-hypnotics. Ann Intern Med. 1972;77:91-100. LinkGoogle Scholar6. KALES A and KALES J. Evaluation and Treatment of Insomnia. New York: Oxford University Press; 1984. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: THOMAS E. FINUCANE, M.D.Affiliations: West Virginia University Morgantown, WV 26506-6302 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 September 1984Volume 101, Issue 3Page: 403-404KeywordsMetabolites ePublished: 1 December 2008 Issue Published: 1 September 1984 PDF downloadLoading ...
220 Randomised controlled trial for the prevention of hepatic encephalopathy after transjugular intrahepatic porto-systemic shunt (TIPS): Comparison between lactitol, rifaximin and no treatment
Authors: A. Masini, C. Efrati, F. Nicolao, M. Merli, A.F. Attili, O. Riggio
Journal: Journal of Hepatology (2004)
S14 The Best Way to Secure a 12-French Intercostal Chest Drain to the Chest Wall
Authors: AJK Wilkinson, SS Lok, EC Thomas
Journal: Thorax (2012)

<h3>Introduction and Objectives</h3> Dislodgement of intercostal chest drains (ICDs) is common, affecting up to 21% of ICDs.<sup>1</sup> Why ICDs dislodge is not well understood. The optimum technique for securing ICDs has never been the subject of a randomised trial. Current BTS guidelines recommend ‘0’ or ‘1’ sutures and caution against excessive adhesive dressings. Adhesive dressings are nevertheless widely used, sometimes instead of sutures. This study aims to identify the best technique for securing ICDs. <h3>Methods</h3> A chest wall model was developed using 7mm medium-density fibreboard with one hole for a 12-French ICD and four smaller holes for sutures. Appropriately qualified doctors secured ICDs to the model with their usual sutures and technique. Some doctors who used small sutures repeated the experiment using larger sutures. The force required to remove the ICD from the model was measured with a Newton metre. A maximum force of 100N was applied, as ICDs snapped at forces over 110N. The force needed to detach ICDs fixed to the experimenter’s chest using adhesive dressings was also measured. <h3>Results</h3> Using ‘1’ sutures, ICDs remained attached even at 100N ‘0’ sutures snapped at 86N ‘2/0’ sutures were most commonly used, but snapped at 57N ‘3/0’ and ‘4/0’ sutures were the least effective; the drain slipped at 25N and 20N respectively. Individual doctors using the same technique with larger sutures (‘1’ or ‘0’ instead of ‘2/0’) attached ICDs more securely (92N vs 57N, p=0.03) though the number of sutures, technique and doctor’s experience had no effect. ICDs detached painlessly from Rocket© dressings at 47N. An improvised tegaderm© dressing was more secure but detached painfully from the skin at 73N (p=0.03). The force required didn’t diminish over 48 hours. <h3>Conclusions</h3> ‘1’ sutures may be the best way to secure an ICD however the force required to pull sutures from the skin is unknown and knots may loosen over time. Using larger sutures improved ICD fixation. Adhesive dressings secure ICDs with similar strength to sutures and may represent an important alternative or adjunct, particularly in patients with fragile skin. <h3>Reference</h3> Davies HE et al. Respirology (2008)13:603–607.
Increased production of luminol enhanced chemiluminescence by the inflamed colonic mucosa in patients with ulcerative colitis.
Authors: S Sedghi, J Z Fields, M Klamut, G Urban, M Durkin, D Winship, D Fretland, M Olyaee, A Keshavarzian
Journal: Gut (1993)

Reactive oxygen species have been implicated as mediators of inflammation in ulcerative colitis. Chemiluminescence is a reliable means of estimating reactive oxygen species in biological media. Increased reactive oxygen species values in the inflamed colonic mucosa in rats were seen by chemiluminescence. The aims of the study were to find out if chemiluminescence is raised in the colonic mucosa of patients with ulcerative colitis and correlates with disease activity, and to elucidate the sources of the chemiluminescence. It was found that reactive oxygen species, as measured by the chemiluminescence technique, are raised in inflamed colonic mucosa and correlates with symptom score, sigmoidoscopic score, disease activity, and activity of the neutrophil enzyme myeloperoxidase. Chemiluminescence was inhibited by a myeloperoxidase inhibitor (azide) and an H2O2 scavenger (catalase) but not by allopurinol, an inhibitor of the enzyme xanthine oxidase. Chemiluminescence was also inhibited by indomethacin, but this did not seem to be related to inhibition of cyclo-oxygenase. These findings suggest that a likely cellular source of reactive oxygen species in the inflamed colon of patients with ulcerative colitis is the neutrophil and that myeloperoxidase conversion of H2O2 to hypochlorous acid, contributes to the chemiluminescence signal and possibly, to the tissue injury. Neither cyclo-oxygenase nor lipoxygenase seem to play a part as sources for the chemiluminescence.
Declining Sex Ratio in a First Nation Community
Authors: Constanze A. Mackenzie, Ada Lockridge, Margaret Keith
Journal: Environmental Health Perspectives (2005)

Members of the Aamjiwnaang First Nation community near Sarnia, Ontario, Canada, voiced concerns that there appeared to be fewer male children in their community in recent years. In response to these concerns, we assessed the sex ratio (proportion of male births) of the Aamjiwnaang First Nation over the period 1984-2003 as part of a community-based participatory research project. The trend in the proportion of male live births of the Aamjiwnaang First Nation has been declining continuously from the early 1990s to 2003, from an apparently stable sex ratio prior to this time. The proportion of male births (m) showed a statistically significant decline over the most recent 10-year period (1994-2003) (m = 0.412, p = 0.008) with the most pronounced decrease observed during the most recent 5 years (1999-2003) (m = 0.348, p = 0.006). Numerous factors have been associated with a decrease in the proportion of male births in a population, including a number of environmental and occupational chemical exposures. This community is located within the Great Lakes St. Clair River Area of Concern and is situated immediately adjacent to several large petrochemical, polymer, and chemical industrial plants. Although there are several potential factors that could be contributing to the observed decrease in sex ratio of the Aamjiwnaang First Nation, the close proximity of this community to a large aggregation of industries and potential exposures to compounds that may influence sex ratios warrants further assessment into the types of chemical exposures for this population. A community health survey is currently under way to gather more information about the health of the Aamjiwnaang community and to provide additional information about the factors that could be contributing to the observed decrease in the proportion of male births in recent years.
Abstract IA14: Novel therapeutic targets in prostate cancer
Authors: Arul M. Chinnaiyan
Journal: Cancer Research (2012)

Abstract Recurrent fusions of ETS genes are considered driving mutations in a diverse array of cancers, including Ewing's sarcoma, acute myeloid leukemia, and prostate cancer. We investigate the mechanisms by which ETS fusions mediate their effects, and find that the product of the predominant ETS gene fusion, TMPRSS2:ERG, interacts in a NA-independent manner with the enzyme poly (ADP-ribose) polymerase 1 (PARP1) and the catalytic subunit of DNA protein kinase (DNAPKcs). ETS gene-mediated transcription and cell invasion require PARP1 and DNAPKcs expression and activity. Importantly, pharmacological inhibition of PARP1 inhibits ETS-positive, but not ETS-negative, prostate cancer xenograft growth. Finally, overexpression of the TMPRSS2:ERG fusion induces DNA damage, which is potentiated by PARP1 inhibition in a manner similar to that of BRCA1/2 deficiency. Citation Format: Arul M. Chinnaiyan. Novel therapeutic targets in prostate cancer [abstract]. In: Proceedings of the AACR Special Conference on Advances in Prostate Cancer Research; 2012 Feb 6-9; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2012;72(4 Suppl):Abstract nr IA14.
Tropical (Filarial) Eosinophilia
Authors: Franklin A. Neva, Eric A. Ottesen
Journal: New England Journal of Medicine (1978)

APPLICATION of the terms tropical eosinophilia, pulmonary eosinophilia and eosinophilic lung to the same clinical entity has led to considerable confusion in the medical literature. The illness was initially described from the tropics, with its main characteristics being extreme blood eosinophilia in association with paroxysmal cough and wheezing, scanty sputum production and nondescript pulmonary markings on x-ray study; weight loss, low-grade fever and adenopathy in some cases suggested a systemic process. Though this syndrome was probably observed much earlier, credit for the best initial descriptions of tropical pulmonary eosinophilia is generally given to the reports from India by Frimodt-Möller and . . .
Abolition of Hanging — A Recent Hullabaloo — From the Sixties to the Seventies
Authors: John Lister
Journal: New England Journal of Medicine (1970)

THE 1957 Homicide Act eliminated capital punishment for murder except in certain circumstances, and in 1965 a five-year trial period of total abolition of the death penalty was introduced. The leaders of all three political parties were known to favor abolition, but it had been agreed that there should be a free vote as a matter of conscience. Moreover, Mr. Heath, the leader of the opposition, had made it clear that he would not make the question of capital punishment an election issue. The decision of the Government, however, to seek a decision from Parliament on whether abolition should be . . .
Upper airways sarcoidosis presenting as obstructive sleep apnoea
Authors: R N H Shah, P R Mills, P J M George, J A Wedzicha
Journal: Thorax (1998)

Sarcoidosis may present in a number of different ways, affecting many organ systems. The case history is presented of a 32 year old woman who presented with symptoms of severe obstructive sleep apnoea (OSA) due to infiltration of the upper airway by sarcoidosis. To our knowledge this presentation of sarcoidosis has not previously been described.
“Stemness” Genomics Law Governs Clinical Behavior of Human Cancer: Implications for Decision Making in Disease Management
Authors: Gennadi V. Glinsky
Journal: Journal of Clinical Oncology (2008)

One of the most significant accomplishments of translational oncogenomics is a realistic promise of efficient diagnostic tests that would facilitate implementation of the concept of individualized cancer therapies. Recent discovery of the BMI1 pathway rule indicates that gene expression signatures (GESs) associated with the "stemness" state of a cell might be informative as molecular predictors of cancer therapy outcome. We illustrate a potential clinical utility of this concept using GESs derived from genomic analysis of embryonic stem cells (ESCs) during transition from self-renewing, pluripotent state to differentiated phenotypes. Signatures of multiple stemness pathways (signatures of BMI1, Nanog/Sox2/Oct4, EED, and Suz12 pathways; transposon exclusion zones and ESC pattern 3 signatures; signatures of Polycomb-bound and bivalent chromatin domain transcription factors) seem informative in stratification of cancer patients into low- and high-intensity treatment groups on the basis of prediction of the long-term therapy outcome. A stemness cancer therapy outcome predictor (CTOP) algorithm combining scores of nine stemness signatures outperforms individual signatures and demonstrates a superior prognostic accuracy in retrospective supervised analysis of large cohorts of breast, prostate, lung, and ovarian cancer patients. Our analysis suggests that stemness genomics law governs clinical behavior of human malignancies and defines epigenetic boundaries of therapy-resistant and -sensitive tumors within distinct stemness/differentiation programs. One of the main conclusions of our analysis is that near-term progress in practical implementation of the concept of personalized cancer therapies would depend on timely delivery to practicing physicians of relevant scientific information regarding the outcome of prospective trials validating prognostic performance of CTOP tests in a clinical setting.
Expanding Access to BRCA1/2 Genetic Counseling with Telephone Delivery: A Cluster Randomized Trial
Authors: A. Y. Kinney, K. M. Butler, M. D. Schwartz, J. S. Mandelblatt, K. M. Boucher, L. M. Pappas, A. Gammon, W. Kohlmann, S. L. Edwards, A. M. Stroup, S. S. Buys, K. G. Flores, R. A. Campo
Journal: JNCI Journal of the National Cancer Institute (2014)

BackgroundThe growing demand for cancer genetic services underscores the need to consider approaches that enhance access and efficiency of genetic counseling. Telephone delivery of cancer genetic services may improve access to these services for individuals experiencing geographic (rural areas) and structural (travel time, transportation, childcare) barriers to access.
LONG TERM CLINICAL OUTCOME OF ANOMALOUS ORIGIN OF RIGHT CORONARY ARTERY FROM LEFT CORONARY CUSP
Authors: Sang Eun Lee, Bon Kwon Koo, Cheol Woong Yu, Ji-Hyun Kim, Kyung Woo Park, Hyun-Jae Kang, Han-Mo Yang, Chang-Hwan Yoon, Jung-Won Suh, Young-Seok Cho, Tae-Jin Youn, Chae In-Ho, Dong-Ju Choi, Hyo-Soo Kim
Journal: Journal of the American College of Cardiology (2012)
Effect of Intravenous Streptokinase on Left Ventricular Function and Early Survival after Acute Myocardial Infarction
Authors: Harvey D. White, Robin M. Norris, Michael A. Brown, Morimasa Takayama, Andrew Maslowski, Nigel M. Bass, John A. Ormiston, Toby Whitlock
Journal: New England Journal of Medicine (1987)

In a double-blind trial of streptokinase for acute myocardial infarction, 219 consecutive patients presenting with infarction within four hours (mean, 3.0±0.8) of the onset of chest pain were randomly assigned to treatment with streptokinase (1.5 million units) or placebo, given intravenously over 30 minutes. The primary end point of the study was left ventricular function in patients with first infarctions. Patients who could undergo beta-blockade also received intravenous propranolol. Heparin (for 48 hours) and a combination of low-dose aspirin and dipyridamole were administered to both groups until cineangiography was performed at three weeks. In the patients with first infarctions treated with streptokinase, the left ventricular ejection fraction was 6 percentage points higher (streptokinase vs. placebo, 59±10.5 vs. 53±13.5 percent; P<0.005), with benefit to patients with either anterior infarction (57±11.9 vs. 49±15.9 percent; P<0.05) or inferior infarction (60±9.1 vs. 55±11.3 percent; P<0.05). Left ventricular function was improved regardless of whether concomitant propranolol was given. Survival (at 30 days) was improved with streptokinase: 2 deaths occurred among 79 patients who received this drug, as compared with 12 deaths among 93 patients who received placebo (2.5 vs. 12.9 percent, P = 0.012). Rates of reinfarction (streptokinase vs. placebo, 3 vs. 1 percent) and requirements for surgery or angioplasty (7 vs. 5 percent) were similar in the two groups. We conclude that administration of intravenous streptokinase (1.5 million units) to patients with a first myocardial infarction results in improved left ventricular function and short-term survival. (N Engl J Med 1987; 317: 850–5.)
Follicular helper T cell signature in type 1 diabetes
Authors: Rupert Kenefeck, Chun Jing Wang, Tauseef Kapadi, Lukasz Wardzinski, Kesley Attridge, Louise E. Clough, Frank Heuts, Alexandros Kogimtzis, Sapna Patel, Miranda Rosenthal, Masahiro Ono, David M. Sansom, Parth Narendran, Lucy S.K. Walker
Journal: Journal of Clinical Investigation (2014)

The strong genetic association between particular HLA alleles and type 1 diabetes (T1D) indicates a key role for CD4+ T cells in disease; however, the differentiation state of the responsible T cells is unclear. T cell differentiation originally was considered a dichotomy between Th1 and Th2 cells, with Th1 cells deemed culpable for autoimmune islet destruction. Now, multiple additional T cell differentiation fates are recognized with distinct roles. Here, we used a transgenic mouse model of diabetes to probe the gene expression profile of islet-specific T cells by microarray and identified a clear follicular helper T (Tfh) cell differentiation signature. Introduction of T cells with a Tfh cell phenotype from diabetic animals efficiently transferred diabetes to recipient animals. Furthermore, memory T cells from patients with T1D expressed elevated levels of Tfh cell markers, including CXCR5, ICOS, PDCD1, BCL6, and IL21. Defects in the IL-2 pathway are associated with T1D, and IL-2 inhibits Tfh cell differentiation in mice. Consistent with these previous observations, we found that IL-2 inhibited human Tfh cell differentiation and identified a relationship between IL-2 sensitivity in T cells from patients with T1D and acquisition of a Tfh cell phenotype. Together, these findings identify a Tfh cell signature in autoimmune diabetes and suggest that this population could be used as a biomarker and potentially targeted for T1D interventions.
STIMULATION OF PULMONARY ARTERIAL ENDOTHELIUM IN DIASTOLIC HEART FAILURE INDUCED PULMONARY HYPERTENSION SIMILAR TO PULMONARY ARTERIAL HYPERTENSION
Authors: Jason N. Salamon, Jeremy Mazurek, Muhammad Iqbal, Siddharth Wartak, Ronald Zolty
Journal: Journal of the American College of Cardiology (2013)
Centennial Physician: Richard Perry, MD, Struggles with the Future
Authors: Fitzhugh Mullan
Journal: Annals of Internal Medicine (1999)

Medical Writings7 September 1999Centennial Physician: Richard Perry, MD, Struggles with the FutureFitzhugh Mullan, MDFitzhugh Mullan, MDBethesda, MD 20814 (Mullan)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-131-5-199909070-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Richard Perry, MD, is a physician of the 20th century. Born before the advent of penicillin, schooled in the days when “imaging” meant x-rays and endoscopes were few, rigid, and of limited value, he has spent most of the century's latter decades as a devout practitioner of personal medical care, bringing increasingly powerful medical science to the lives of his patients. He loves his calling, but as he faces the 21st century, his practice and his medical values are in trouble.Perry is a general internist (American Board of Internal Medicine, 1962)—an unapologetic primary care physician who cares efficiently for ... Author, Article, and Disclosure InformationAuthors: Fitzhugh Mullan, MDAffiliations: Bethesda, MD 20814 (Mullan)Grant Support: By the Pew Charitable Trusts, the Robert Wood Johnson Foundation, and the Milbank Memorial Fund.Corresponding Author: Fitzhugh Mullan, MD, Health Affairs/Project Hope, Suite 600, 7500 Georgetown Road, Bethesda, MD 20814; e-mail, [email protected]org. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 7 September 1999Volume 131, Issue 5Page: 395-398KeywordsAdolescentsCardiac surgeryCataract surgeryChemotherapyDiagnostic medicineForecastingHealth care qualityPatient advocacyPatientsVision ePublished: 15 August 2000 Issue Published: 7 September 1999 Copyright & PermissionsCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...