tbuckley/cabot-search huggingface dataset:
Better efficacy of methotrexate given by intramuscular injection than orally in patients with rheumatoid arthritis
Authors: J Wegrzyn, P Adeleine, P Miossec
Journal: Annals of the Rheumatic Diseases (2004)

<b>Objective:</b> To compare the clinical efficacy of methotrexate and tolerance to the drug in patients with rheumatoid arthritis who were switched from intramuscular to oral administration because of a shortage of the intramuscular preparation. <b>Methods:</b> 143 patients were switched from intramuscular to oral methotrexate. Of these, 47 were switched back to the intramuscular form. A multiple choice questionnaire was sent by mail to evaluate clinical and biological criteria of efficacy and tolerance. <b>Results:</b> When methotrexate was first switched from intramuscular to oral administration, increased disease activity, exacerbation of morning pain and hand stiffness, duration of morning stiffness, increased joint pain, and increased joint swelling were observed. There was a greater frequency of gastrointestinal symptoms, but without a significant increase in liver abnormalities. When intramuscular methotrexate became available again, 47 of the 143 patients were switched back and were followed for at least three months. On average, disease manifestations were improved and side effects reduced by the switch. <b>Conclusions:</b> Methotrexate given intramuscularly had improved clinical efficacy with fewer side effects than given orally. Intramuscular methotrexate administration should be considered when rheumatoid arthritis remains active in spite of high dose oral methotrexate.
STUDIES UPON THE ETIOLOGY OF DENGUE FEVER
Authors: Charles W. Duval, William H. Harris
Journal: The Journal of Experimental Medicine (1924)

We have described the cultivation of a minute organism, upon the special media devised by Noguchi for growing spirochetal organisms, that gives rise to pyrexial and leucocytic reactions in the guinea pig. The reaction in the animal following the injection of culture filtrate is identical with that induced by the inoculation of human dengue blood. While it is possible, it is hardly probable that the infection of animals with cultures of this microorganism several generations removed from the original is due to a mechanically transferred virus with which the visible microorganism cultivated became accidentally associated. Furthermore, it is unlikely that such a virus would remain viable and be carried over to subcultures in sufficient numbers to infect the animal. The microorganisms appear in culture as globoid bodies measuring from 0.1 to 0.3micro in diameter and are arranged singly, in pairs, and in short chains. They readily pass through the Berkefeld filter (N and V) and the filtrate gives rise to a characteristic reaction in the inoculated guinea pig. The filtrate yields in subplants the same globoid bodies of the original culture. Initial cultures have been obtained directly from the blood of the human case as well as from the blood of guinea pigs reacting to the human material. However, only early generations retain the degree of virulence necessary to cause the experimental reaction, the culture of remote generation failing to infect. As far as known this minute organism has characters in common with the globoid bodies of Flexner and Noguchi obtained from cases of poliomyelitis. In plasma semisolid medium the striking feature indicative of growth is colonization, which in itself serves to differentiate the opalescence of the medium occasioned by disintegration of the contained tissue. As regards the presence of spirochetal organisms in the blood of dengue fever, we may state that examination was made of the material from human cases and from. a large number of inoculated animals. Despite the most careful search with the dark-field microscope and repeated examinations of blood specimens stained by the best methods, we have been unable to find any demonstrable spiral organism in the blood of dengue patients or in the experimentally inoculated animal. The minute organism herein described is frequently present in cultures of the blood of human dengue and of animals inoculated with dengue material. The inoculation of the culture into guinea pigs produces a response comparable to that occurring in the human case, and that induced by the injection of human dengue blood in guinea pigs. While we are of the opinion that the anaerobic globular bodies described may bear etiological relationship to dengue, we realize that further proof and confirmation of our work are required to establish the connection.
Changing the Paradigms of Treatment in Peripheral T-cell Lymphoma: From Biology to Clinical Practice
Authors: Owen A. O'Connor, Govind Bhagat, Karthik Ganapathi, Martin Bjerregaard Pedersen, Francesco D'Amore, Dejan Radeski, Susan E. Bates
Journal: Clinical Cancer Research (2014)

Abstract Despite enormous advances in our understanding of aggressive lymphomas, it is clear that progress in the peripheral T-cell lymphomas (PTCL) has lagged well behind other B-cell malignancies. Although there are many reasons for this, the one commonly cited notes that the paradigms for diffuse large B-cell lymphoma (DLBCL) were merely applied to all patients with PTCL, the classic “one-size-fits-all” approach. Despite these challenges, progress is being made. Recently, the FDA has approved four drugs for patients with relapsed/refractory PTCL over the past 5 years, and if one counts the recent Japanese approval of the anti-CCR4 monoclonal antibody for patients with adult T-cell leukemia/lymphoma, five drugs have been approved worldwide. These efforts have led to the initiation of no fewer than four randomized clinical studies exploring the integration of these new agents into standard CHOP (cyclophosphamide–Adriamycin–vincristine–prednisone)–based chemotherapy regimens for patients with newly diagnosed PTCL. In addition, a new wave of studies are exploring the merits of novel drug combinations in the disease, an effort to build on the obvious single-agent successes. What has emerged most recently is the recognition that the PTCL may be a disease-characterized by epigenetic dysregulation, which may help explain its sensitivity to histone deacetylase (HDAC) inhibitors, and open the door for even more creative combination approaches. Nonetheless, advances made over a relatively short period of time are changing how we now view these diseases and, hopefully, have poised us to finally improve its prognosis. See all articles in this CCR Focus section, “Paradigm Shifts in Lymphoma.” Clin Cancer Res; 20(20); 5240–54. ©2014 AACR.
Trends in the Proportion of Patients With Lung Cancer Meeting Screening Criteria
Authors: Yi Wang, David E. Midthun, Jason A. Wampfler, Bo Deng, Shawn M. Stoddard, Shuo Zhang, Ping Yang
Journal: JAMA (2015)

Lung cancer screening using low-dose computed tomography is recommended for high-risk individuals by professional associations including the US Preventive Services Task Force (USPSTF).1 The implications of the USPSTF screening criteria were investigated in a retrospective study of a well-defined population to demonstrate trends in the proportion of lung cancer patients meeting the criteria over 28 years.
Salivary Gland Tumors in Atomic Bomb Survivors, Hiroshima-Nagasaki, 1957 to 1970
Authors: Joseph L. Belsky
Journal: JAMA (1972)

Salivary gland tumors were found to be increased more than fivefold among survivors of the atomic bombs who had been exposed to high doses of radiation, compared with nonirradiated controls. Despite a small number of proven cases, (22 in all) this finding was determined to be highly significant for the entire group and for histologically malignant types, but not for benign tumors. This represents a new finding in the search for late sequelae of the atomic bombs. In our study the prevalence of tumors was related to younger age at exposure, but not to the interval between exposure and diagnosis. There was no clear association between amount of A-bomb radiation and cell type. The present findings are compared with other reports concerned with radiation and salivary gland neoplasia.
LOCAL PROGRESSION WITH SPONTANEOUS REGRESSION OF TUBERCULOSIS IN THE BONE MARROW OF RABBITS, CORRELATED WITH A TRANSITORY ANEMIA AND LEUCOPENIA AFTER INTRAVENOUS INOCULATION
Authors: Charles A. Doan, Florence R. Sabin
Journal: The Journal of Experimental Medicine (1927)

In this series of rabbits it was found that the rabbits dying during the 1st month after an injection of I or 2 mg. of bovine tubercle bacilli show the same conditions: extreme tuberculosis of the lungs, acute splenic tumor with tuberculosis, involvement of the lymph glands, an occasional small tubercle in the liver and extensive tuberculosis of the bone marrow. The peripheral blood has shown a sharp fall in the platelet count, an anemia and a fall in the granulocytic strain of white cells, and these changes have been correlated with the condition of the bone marrow. There has also been a rise in monocytes and a fall in lymphocytes, to a reversal of the normal ratio. When the rabbits have survived the first acute phase of the disease longer than 3 to 4 weeks, there have been signs in the peripheral blood of a recovery of the bone marrow; the first indication of this has been an increase in platelets, then a rise in hemoglobin followed in 1 or 2 days by a rise in red cells and later a return of the three strains of granulocytes. The bone marrow has shown a rapid spontaneous disintegration of the epithelioid cells correlated with the appearance of increased evidence of acid-fast debris in clasmatocytes, especially clear in those that lie along the vessels. The animals that have survived into the 3rd month have all shown a hyperplastic phase of the healing marrow, both the red cells and all types of the granulocytes appearing in the peripheral blood in numbers above the normal. The epithelioid cells originally containing many bacilli all disappear from the marrow and the only sign left, possibly suggestive of the tuberculosis, is the acid-fast granules in the clasmatocytes. Finally, the marrow becomes entirely normal, giving the normal number of red cells and granulocytes to the blood. Thus, bone marrow in the rabbit has become involved in every instance with the injection of massive doses of viable bacilli. The findings at autopsy in those animals followed during the early reaction to infection confirm this directly and, since the curves of the cells in the peripheral blood of the more chronic animals were the same during the early stages of the disease as in those that died, the same conclusion seems justified from indirect inference for them. The method of healing has been a rapid disintegration of the epithelioid cells without caseation. The bone marrow heals itself entirely regardless of the progress of the disease elsewhere, so that one sees the remarkable condition of an animal recovering from the anemia and leucopenia while dying of tuberculosis elsewhere. The spleen also shows a tendency toward spontaneous healing. In the animals that have lived beyond 100 days there has been some gradual lessening of the diffuse distribution and extent of pulmonary lesions with the development of cavitation together with a marked involvement of the kidneys and lesions in the eyes.
Prophylactic appendicectomy during caesarean section in a developing community.
Authors: W O Chukudebelu, W I Onuigbo
Journal: BMJ (1979)

was admitted to hospital in August.Each afternoon he became febrile, ataxic, and irritable and then after about an hour fell into a deep sleep.On one occasion his speech was slurred and the left side of his body twitched.He also had transient blank spells.By October his notes contained results of 119 investigations, most of which were normal.An electroencephalogram had shown excess fast activity: the parents denied the possibility of drug ingestion.Anticonvulsants were ineffective.Eventually prednisolone was started empirically with dramatic improvement.The child was briefly discharged but returned acutely confused.Myoclonic jerks were associated with a generalised paroxysmal abnormality on the electroencephalogram. Urine taken on admission contained a phenothiazine metabolite, and repeated specimens confirmed high concentrations of the substance.The mother-This 29-year-old woman had spent every day but one with her son on the ward and seemed to us to be a very good mother.Her hospital notes were therefore startling.She had been admitted to Frenchay Hospital in 1975 for investigation of a right hemiparesis.The history ob- tained there, partly from her and partly from other hospitals, left no doubt that she suffered from the Munchausen syndrome.A psychiatrist had considered her "a gross hysterical psychopath with self-destructive tenden- cies."
Formation of novel non-cyclooxygenase-derived prostanoids (F2-isoprostanes) in carbon tetrachloride hepatotoxicity. An animal model of lipid peroxidation.
Authors: J D Morrow, J A Awad, T Kato, K Takahashi, K F Badr, L J Roberts, R F Burk
Journal: Journal of Clinical Investigation (1992)

These studies examine the in vivo formation of a unique series of PGF2-like compounds (F2-isoprostanes) derived from free radical-catalyzed nonenzymatic peroxidation of arachidonic acid. We have previously shown that levels of these compounds increase up to 50-fold in rats administered CCl4. To understand further the formation of these compounds in vivo, we carried out a series of experiments assessing factors influencing their generation. After CCl4 (2 ml/kg) was administered to rats, plasma F2-isoprostanes increased 55-fold by 4 h. Levels declined thereafter, but at 24 h, they were still elevated 21-fold, indicating continued lipid peroxidation. Pretreatment of rats with isonicotinic acid hydrazide and phenobarbital to induce cytochrome P-450 enhanced the production of F2-isoprostanes after CCl4 administration eightfold and fivefold, respectively, whereas inhibition of the cytochrome P-450 system with SKF-525A and 4-methylpyrazole decreased formation of F2-isoprostanes after CCl4 by 55 and 82%, respectively. Further, the glutathione-depleting agents buthionine sulfoximine and phorone augmented the F2-isoprostane response to CCl4 by 22- and 11-fold, respectively. F2-isoprostanes are formed in situ esterified to lipids and, in addition to increases in levels of free F2-isoprostanes in the circulation, levels of F2-isoprostanes esterified to lipids in various organs and plasma also increase sharply during CCl4 poisoning. The measurement of F2-isoprostanes may facilitate investigation of the role of lipid peroxidation in human diseases.
Myasthenia Gravis Associated With Wasp Sting
Authors: Joel Brumlik
Journal: JAMA (1976)

A clinical picture indistinguishable fro, but not therefore identical with, myasthenia gravis (ocular form) developed within 24 hours of a wasp sting. Because of the close temporal association of events, operative mechanisms may be either an immediate hypersensitivity reaction to some components of wasp venom or a direct toxic effect of these substances on acetylcholine synthesis, release, or degradation. Theoretical considerations from the literature and the lack of immunologic abnormalities in the patient suggest that the latter may be correct. Unique host conditions must have been present at the time of the sting, implying latent or subclinical myasthenia gravis.
Effect of a Mediterranean-Style Diet on Endothelial Dysfunction and Markers of Vascular Inflammation in the Metabolic Syndrome
Authors: Katherine Esposito, Raffaele Marfella, Miryam Ciotola, Carmen Di Palo, Francesco Giugliano, Giovanni Giugliano, Massimo D'Armiento, Francesco D'Andrea, Dario Giugliano
Journal: JAMA (2004)

The metabolic syndrome has been identified as a target for dietary therapies to reduce risk of cardiovascular disease; however, the role of diet in the etiology of the metabolic syndrome is poorly understood.To assess the effect of a Mediterranean-style diet on endothelial function and vascular inflammatory markers in patients with the metabolic syndrome.Randomized, single-blind trial conducted from June 2001 to January 2004 at a university hospital in Italy among 180 patients (99 men and 81 women) with the metabolic syndrome, as defined by the Adult Treatment Panel III.Patients in the intervention group (n = 90) were instructed to follow a Mediterranean-style diet and received detailed advice about how to increase daily consumption of whole grains, fruits, vegetables, nuts, and olive oil; patients in the control group (n = 90) followed a prudent diet (carbohydrates, 50%-60%; proteins, 15%-20%; total fat, <30%).Nutrient intake; endothelial function score as a measure of blood pressure and platelet aggregation response to l-arginine; lipid and glucose parameters; insulin sensitivity; and circulating levels of high-sensitivity C-reactive protein (hs-CRP) and interleukins 6 (IL-6), 7 (IL-7), and 18 (IL-18).After 2 years, patients following the Mediterranean-style diet consumed more foods rich in monounsaturated fat, polyunsaturated fat, and fiber and had a lower ratio of omega-6 to omega-3 fatty acids. Total fruit, vegetable, and nuts intake (274 g/d), whole grain intake (103 g/d), and olive oil consumption (8 g/d) were also significantly higher in the intervention group (P<.001). The level of physical activity increased in both groups by approximately 60%, without difference between groups (P =.22). Mean (SD) body weight decreased more in patients in the intervention group (-4.0 [1.1] kg) than in those in the control group (-1.2 [0.6] kg) (P<.001). Compared with patients consuming the control diet, patients consuming the intervention diet had significantly reduced serum concentrations of hs-CRP (P =.01), IL-6 (P =.04), IL-7 (P = 0.4), and IL-18 (P = 0.3), as well as decreased insulin resistance (P<.001). Endothelial function score improved in the intervention group (mean [SD] change, +1.9 [0.6]; P<.001) but remained stable in the control group (+0.2 [0.2]; P =.33). At 2 years of follow-up, 40 patients in the intervention group still had features of the metabolic syndrome, compared with 78 patients in the control group (P<.001).A Mediterranean-style diet might be effective in reducing the prevalence of the metabolic syndrome and its associated cardiovascular risk.
Regional wall motion abnormalities after prolonged exercise in the normal left ventricle.
Authors: P S Douglas, M L O'Toole, J Woolard
Journal: Circulation (1990)

To determine whether regional wall motion abnormalities exist or contribute to left ventricular dysfunction, we obtained two-dimensional echocardiograms in 12 athletes before (baseline), immediately after (race finish), and 1 day after (recovery) the Hawaii Ironman Triathlon (a 3.9-km swimming, 180.2-km bicycling, and 42.2-km running event). Left ventricular short-axis and apical four-chamber views were computer digitized and divided into six segments, and radial chord shortening and area ejection fraction were calculated. Global ejection fraction fell at race finish (51% versus 46%, p less than 0.05) but recovered by 1 day (54%, p less than 0.01 by repeated-measures analysis of variance). With the apical four-chamber view, midseptal and apical-septal motion were reduced at race finish but returned to baseline during recovery (midseptal radial chord shortening: 21%, 8%, 22%; apical-septal radial chord shortening: 27%, 12%, 25%; midseptal area ejection fraction: 39%, 30%, 40%; apical-septal area ejection fraction: 44% baseline, 33% race finish, 43% recovery; all p less than 0.01). In contrast, with the parasternal short-axis view, wall motion did not change at race finish but tended to be elevated during recovery and became significant for anteroseptal motion (radial chord shortening: 29%, 30%, 36%; area ejection fraction: 49% baseline, 51% race finish, 58% recovery; both p less than 0.05). Lateral wall motion was unchanged. In addition, an index of septal curvature was calculated using the ratio of the septal-lateral wall minor axis to the perpendicular anteroposterior minor axis. At all three data collections, this ratio remained close to 1.0 at end systole and end diastole.(ABSTRACT TRUNCATED AT 250 WORDS)
Mutagenesis Reveals a Role for ABP/GRIP Binding to GluR2 in Synaptic Surface Accumulation of the AMPA Receptor
Authors: Pavel Osten, Latika Khatri, Joey L Perez, Georg Köhr, Guenter Giese, Christopher Daly, Torsten W Schulz, Allen Wensky, Laveria M Lee, Edward B Ziff
Journal: Neuron (2000)
New breath technology identifies changes that lead to stomach cancer
Authors: J. Wise
Journal: BMJ (2015)

Nanoarray analysis, a technology that senses tiny changes in volatile organic compounds in exhaled breath, could be a useful non-invasive screening tool for stomach cancer, research in the journal Gut has concluded.1

No reliable accurate and non-invasive screening test is available for gastric cancer and related pre-cancerous lesions. Most patients with gastric cancer have it diagnosed at an advanced stage, when the chance of survival is relatively poor.

The researchers collected 968 breath samples from 484 patients in …
Delayed Emptying of Gastric Stump
Authors: C. Gale
Journal: BMJ (1957)

Because of heavy pressure on our space, correspondents are asked to keep their letters short.Post-maturity SIR,-In your annotation on the subject of post-maturity (Journal, April 13, p. 876), you end with Greenhill's dangerous assertion that " if the cervical canal is taken up and the external os is not closed, the patient is near, at, or after term."The implied corollary is that, if the cervix is not taken up, term has not been reached.While in the normal case the taking up of the cervix (which is a sign that labour is soon to begin) occurs more or less simul- taneously with maturation of the foetus, it is wrong to assume that this happy coincidence is true in every case.A premature labour, say at 32 weeks, is preceded by the taking up of the cervix, and, on the other hand, in a prolonged pregnancy the foetus may die in utero because its growing demands exceed the diminishing ability of the dying placenta to supply it, while the cervix remains long and closed because the uterus is not yet ready for action.No, Sir, it is not enough to depend on the state of the cervix to decide whether term has been reached.The calculation of the duration of pregnancy requires careful assessment of a number of details-the menstrual history, comparison of the size of the uterus in early pregnancy with the estimated duration, the time when movements are first felt, the girth in late pregnancy, the clinical assessment of the size of the foetal head, the x-ray appearances of the foetus and its ossification centres, and last, and probably least, the state of the cervix.A laisser faire attitude is probably better than ill-considered, brash interference, but careful clinical assessment of every detail is surely better than either.-Iam, etc.