tbuckley/cabot-search huggingface dataset:
Time trends in hospitalization and discharge status for cirrhosis and portal hypertension in the united states
Authors: Jayant A. Talwalkar
Journal: Hepatology (2010)

I read with interest the article by Jepsen and colleagues1 in a recent issue of Hepatology. In the United States, cirrhosis and portal hypertension are also considered diseases of major public health importance. However, details regarding national time trends associated with hospitalization and discharge status for cirrhosis and portal hypertension are not widely reported. Data from the National Inpatient Sample (NIS) for the period of 1999-2008 were recently examined for this population. The Healthcare Cost and Utilization Project Internet tool2 was used to extract information from the NIS on discharges, length of stay, and discharge patterns. Patients with cirrhosis and complications of portal hypertension were identified with the appropriate codes from the International Classification of Diseases, Ninth Revision, Clinical Modification (571.0, 571.1, 571.2, 571.3, 571.40-571.49, 571.5, 571.6, 571.8, 571.9, 456.0, 456.20-456.21, 572.0, 576.0, 572.2, and 572.4); these codes include conditions such as variceal bleeding, ascites, hepatic encephalopathy, and hepatorenal syndrome. According to this analysis, 1,450,759 hospitalizations were recorded over the 10-year period (Table 1), and there were 18% more admissions in 2008 versus 1999. Notably, the average length of stay did not significantly change during this period (from 6.8 days in 1999 to 6.4 days in 2008). Remarkably, the overall in-hospital mortality rate decreased by 30% (from roughly 10% to 7%). However, increases in the use of skilled rehabilitation/nursing facilities and home health care from 12% and 7.7%, respectively, in 1999 to 14% and 11.4%, respectively, in 2008 were observed. Individuals 65 years old or older represented 25% of all admissions for cirrhosis and portal hypertension in 2008. Accounting for known limitations within the NIS,3 I find that these results underscore the rising disease burden and economic impact of cirrhosis and portal hypertension in the United States. The exclusion of patients with cirrhosis and hepatocellular carcinoma to highlight nonmalignant complications implies that the burden of disease is even higher. The combination of more hospitalizations and reduced in-hospital mortality rates suggests that evidence-based care may be translating into clinical benefits. In contrast, the pattern of hospitalizing older patients requiring discharge to nursing-based care also raises the specter of frequent yet unplanned hospital readmission. The severity of illness or variations in the quality of care are likely to influence readmission in this respect. Further studies are needed to identify the reasons for increased hospital use because emerging alternatives such as telemonitoring4 for high-risk patients could have significant implications for managing this disease nationally. Jayant A. Talwalkar M.D., M.P.H.*, * Advanced Liver Diseases Study Group, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN.
Enhancing the functional maturity of induced pluripotent stem cell–derived human hepatocytes by controlled presentation of cell–cell interactions in vitro
Authors: Dustin R. Berger, Brenton R. Ware, Matthew D. Davidson, Samuel R. Allsup, Salman R. Khetani
Journal: Hepatology (2014)

Induced pluripotent stem cell‐derived human hepatocyte‐like cells (iHeps) could provide a powerful tool for studying the mechanisms underlying human liver development and disease, testing the efficacy and safety of pharmaceuticals across different patients (i.e., personalized medicine), and enabling cell‐based therapies in the clinic. However, current in vitro protocols that rely upon growth factors and extracellular matrices (ECMs) alone yield iHeps with low levels of liver functions relative to adult primary human hepatocytes (PHHs). Moreover, these low hepatic functions in iHeps are difficult to maintain for prolonged times (weeks to months) in culture. Here, we engineered a micropatterned coculture (iMPCC) platform in a multiwell format that, in contrast to conventional confluent cultures, significantly enhanced the functional maturation and longevity of iHeps in culture for at least 4 weeks in vitro when benchmarked against multiple donors of PHHs. In particular, iHeps were micropatterned onto collagen‐coated domains of empirically optimized dimensions, surrounded by 3T3‐J2 murine embryonic fibroblasts, and then sandwiched with a thin layer of ECM gel (Matrigel). We assessed iHep maturity by global gene expression profiles, hepatic polarity, secretion of albumin and urea, basal cytochrome P450 (CYP450) activities, phase II conjugation, drug‐mediated CYP450 induction, and drug‐induced hepatotoxicity. Conclusion : Controlling both homotypic interactions between iHeps and heterotypic interactions with stromal fibroblasts significantly matures iHep functions and maintains them for several weeks in culture. In the future, iMPCCs could prove useful for drug screening, studying molecular mechanisms underlying iHep differentiation, modeling liver diseases, and integration into human‐on‐a‐chip systems being designed to assess multiorgan responses to compounds. (H epatology 2015;61:1370–1381)
Hodgkin's Disease: Historical Perspective, Current Status, And Future Directions
Authors: M. J. Lacher
Journal: CA A Cancer Journal for Clinicians (1985)

The extraordinary success that has been achieved in prolonging the life of the pa tient with Hodgkin's disease has created new dilemmas and questions: Is initial combined modality (radiation therapy and chemotherapy) better than radiation ther apy alone?How extensive and intensive should the radiation therapy be?If che motherapy is given, what form should it take (MOPP, COPP, Ch1VPP, TVPP, ABVD, etc.*)?Is the staging laparotomy/ splenectomy really necessary?Are the risks of developing second primary tumors and 6MOPP = mechlorethamine, Oncovin (yin cristine), procarbazine, and prednisone.COPP = Cytoxan (cyclophosphamide), On covin (yincristine), procarbazine, and pred nisone.Ch1VPP = chlorambucil, vinblastine, pro carbazine, and prednisone.TVPP = thiotepa, vinblastine, procarbazine, and prednisone.ABVD = Adriamycin (doxorubicin), bleo mycin, vinblastine, and dimethyl triazeno im idazole carboxamide.TBP = thiotepa, bleomycin, and prednisone.
Ex Vivo transduced liver progenitor cells as a platform for gene therapy in mice
Authors: Sihong Song, Rafal P. Witek, Yuanqing Lu, Young-Kook Choi, Donghang Zheng, Marda Jorgensen, Chengwen Li, Terence R. Flotte, Byron E. Petersen
Journal: Hepatology (2004)

Allogeneic stem cell-based transplants may be limited by allograft rejection, as is seen with conventional organ transplantation. One way to avert such a response is to use autologous stem cells, but that may carry the risk of recurrence of the original disease, particularly in the context of a genetic defect. We investigated the potential for gene modification of autologous stem cells to avoid both problems, using recombinant adenoassociated virus vector expressing human α1-antitrypsin in murine liver progenitor cells. We showed that recombinant adenoassociated virus 1 was the most efficient vector for liver progenitor cell transduction among five different serotypes of recombinant adenoassociated virus vectors. Ex vivo infected green fluorescent protein-positive liver progenitor cells from C57BL/6 mice with recombinant adenoassociated virus 1-vector-expressing human α1 antitrypsin were transplanted into the liver of monocrotaline-treated and partial-hepatectomized C57BL/6 recipients. Using green fluorescent protein as a donor marker, we were able to determine that at 18 weeks after transplantation, approximately 40% to 50% of the regenerated liver was green fluorescent protein positive. In addition, transgene expression (serum human α1-antitrypsin) was sustained for the length of the study (18 weeks after transplantation). Immunostaining revealed approximately 5% to 10% of repopulating liver cells expressing human α1-antitrypsin. In conclusion, this study demonstrated the feasibility of long-term engraftment and stability of transgene expression form genetically modified liver progenitor cells with a recombinant adenoassociated virus vector and implies a novel approach to gene therapy for treatment of liver diseases, such as α1-antitrypsin deficiency. (Hepatology 2004;40:918-924).
Injury Science Comes of Age
Authors: Susan P. Baker
Journal: JAMA (1989)

<i>Injury:</i>the word derives from the Latin word for "not right"—an appropriate term for the cause of more than 150 000 deaths annually in the United States, 2.3 million hospitalizations, annual costs of $158 billion,<sup>1</sup>and unmeasurable grief and suffering. "Not right" also describes the failure, until recently, of most health professionals and their institutions to give appropriate attention to the major cause of lost potential years of life before retirement. Early workers in injury prevention would therefore be surprised and pleased thatThe Journalis devoting this issue to injuries. The work of many pioneers has been crucial to the development and recognition of<i>injury science</i>, which is the prevention and control of injuries based on relevant disciplines such as epidemiology; biomechanics; physics; ergonomics; law; and the political, behavioral, and medical sciences. This editorial describes eight scientists whose work has moved the field forward; each made major contributions
NOTES ON THE SUBCUTANEOUS ABSORPTION AND THE QUANTITATIVE ESTIMATION OF CHOLESTEROL
Authors: Harry J. Corper
Journal: The Journal of Experimental Medicine (1915)

Cholesterol, in 0.1 gram amounts, melted in a compact mass and inserted into the subcutaneous tissues of the back of the guinea pig, is slowly removed, as determined by chemical analyses. The rate of removal is probably greatly dependent upon the physical state of the cholesterol. The quantitative estimation of cholesterol by the method previously described can not be shortened and simplified by the direct saponification of the tissues by means of 5 per cent. sodium alcoholate or a strong (50 per cent.) solution of sodium hydroxide, instead of saponifying the alcohol-ether extract.
Cross-border healthcare in the European Union: clarifying patients' rights
Authors: H. Legido-Quigley, I. Passarani, C. Knai, R. Busse, W. Palm, M. Wismar, M. McKee
Journal: BMJ (2011)

The adoption of a new directive on cross-border healthcare in Europe could bring clarity for patients, health professionals, and policy makers, as well as raising awareness of how healthcare differs between EU member states, say <b>Helena Legido-Quigley and colleagues</b>
Load dependence of proximal tubular bicarbonate reabsorption in chronic metabolic alkalosis in the rat.
Authors: D A Maddox, F J Gennari
Journal: Journal of Clinical Investigation (1986)

Studies were undertaken in Munich-Wistar rats to determine whether maintenance of chronic metabolic alkalosis (CMA) is associated with an increase in proximal HCO3- reabsorption, or whether a reduction in glomerular filtration rate (GFR) is required to sustain the elevated plasma HCO3- concentration. Superficial single nephron glomerular filtration rate (SNGFR), and absolute proximal HCO-3 (APRHCO3) and water (APRH2O) reabsorption were measured 20 +/- 3 d after the induction of CMA in eight rats and the results compared with seven age-matched control animals. Plasma [HCO3-] was 39.1 +/- 1.8 mM in CMA rats compared with 26.0 +/- 0.4 mM in controls (P less than 0.001). In the CMA rats, SNGFR was 44.8 +/- 1.1 vs. 38.2 +/- 2.1 nl/min in controls (P less than 0.025). As a result, the single nephron filtered load of HCO3- (FLHCO3) increased from 1,147 +/- 61 pmol/min in control to 2,040 +/- 108 pmol/min in CMA (P less than 0.001). APRHCO3 increased by greater than 65%, from 970 +/- 65 pmol/min in control to 1,624 +/- 86 pmol/min in CMA (P less than 0.001). APRH2O increased from 18.4 +/- 1.6 nl/min in control to 24.0 +/- 0.8 nl/min in CMA (P less than 0.005). Tubular hypertrophy resulted in an increase in the length of the proximal convoluted tubule from 5.6 +/- 0.2 to 6.5 +/- 0.2 mm (P less than 0.005). The pattern of HCO3- reabsorption along the length of the proximal convoluted tubule in CMA was indistinguishable from that found in normal rats in which FLHCO3 was varied acutely by altering SNGFR. The increase in tubular length accounted for only 30% of the increase in APRH2O and 15% of the increase in APRHCO3. We conclude that a sustained reduction in GFR is not required for maintenance of CMA in the rat. If GFR is chronically restored to normal levels, the alkalosis is maintained by an increase in APRHCO3. The increase in reabsorption is accounted for by tubular hypertrophy, a chronic adaptive response, and a load-dependent response that is indistinguishable from that seen in normal rats when FLHCO3 is increased acutely by increasing SNGFR.
Differentiation of Certain Platelet Factors Related to Blood Coagulation
Authors: ERWIN DEUTSCH, SHIRLEY A. JOHNSON, WALTER H. SEEGERS
Journal: Circulation Research (1955)

Study of the platelets from the viewpoint of the blood coagulation mechanisms seems likely to be helpful for increasing our knowledge of thrombosis, and bleeding tendencies in thrombasthenias and thrombopathias. A logical approach to their study is the differentiation of their properties and where possible to ascribe those properties to individual components. Platelet factors 1, 3 and 4 are considered from that viewpoint. The first accelerates the formation of thrombin in a manner analogous to serum Ac-globulin. Factor 3 is required for the development of threone activity, and factor 4 has antiheparin properties.
If devolved facilities are used, processes may be streamlined
Authors: T. Heymann
Journal: BMJ (1998)

The aftermath of the Bristol caseCase arose through a failure of action, not of detection Editor-Smith refers to "key protagonists overreacting" in his editorial on the Bristol case. 1 He joins "even the strongest supporters of the Labour government" in bemoaning "its excessive concern with media opinion."Yet he tells us (and, from his privileged platform, the world) that this case is a "once in a lifetime drama. .., Shakespearean in its scale and structure," which will have the result that "the trust that patients place in their doctors. ..will never be the same again."This is a strange stance for the editor of a scientific journal committed to encouraging rational ideas in medicine.Dramas like this (even dramas that occur more often than once in a lifetime) are certainly "powerful levers for change."But that is not a reason for senior medical journals to seize on them and use them to promote pre-existing agendas of change that have only a tangential bearing.The lesson of the Bristol tragedy, when the dust and the shouting outside the General Medical Council have subsided, is that there was an inexcusable failure of existing mechanisms of control.The tragedy provides no rational support for the wholesale imposition of systems of monitoring
MicroRNA-221 regulates FAS-induced fulminant liver failure
Authors: Amar Deep Sharma, Nidhi Narain, Eva-Maria Händel, Marcus Iken, Nishant Singhal, Toni Cathomen, Michael P. Manns, Hans R. Schöler, Michael Ott, Tobias Cantz
Journal: Hepatology (2011)

Abstract Death receptor-mediated apoptosis of hepatocytes contributes to hepatitis and fulminant liver failure. MicroRNAs (miRNAs), 19–25 nucleotide-long noncoding RNAs, have been implicated in the posttranscriptional regulation of the various apoptotic pathways. Here we report that global loss of miRNAs in hepatic cells leads to increased cell death in a model of FAS/CD95 receptor-induced apoptosis. miRNA profiling of murine liver identified 11 conserved miRNAs, which were up-regulated in response to FAS-induced fulminant liver failure. We show that ectopic expression of miR-221, one of the highly up-regulated miRNAs in response to apoptosis, protects primary hepatocytes and hepatoma cells from apoptosis. Importantly, in vivo overexpression of miR-221 by adeno-associated virus serotype 8 (AAV8) delays FAS-induced fulminant liver failure in mice. We additionally demonstrate that miR-221 regulates hepatic expression of p53 up-regulated modulator of apoptosis ( Puma ), a well-known proapoptotic member of the Bcl2 protein family. Conclusion: We identified miR-221 as a potent posttranscriptional regulator of FAS-induced apoptosis. miR-221 may serve as a potential therapeutic target for the treatment of hepatitis and liver failure. (HEPATOLOGY 2011;)
Brief Communication: Fatal Human Metapneumovirus Infection in Stem-Cell Transplant Recipients
Authors: Janet A. Englund, Michael Boeckh, Jane Kuypers, W. Garrett Nichols, Robert C. Hackman, Rhoda A. Morrow, David N. Fredricks, Lawrence Corey
Journal: Annals of Internal Medicine (2006)

Background: Human metapneumovirus (hMPV), a recently discovered respiratory virus, is associated with clinical disease in young and elderly persons. Objective: To determine the importance of hMPV in hematopoietic stem-cell transplant recipients. Design: Retrospective survey of patients with consecutive residual bronchoalveolar lavage (BAL) samples. Setting: Referral cancer center. Patients: Hematopoietic stem-cell transplant recipients who underwent BAL because of lower respiratory tract disease. Measurements: Bronchoalveolar lavage specimens were assayed by quantitative real-time polymerase chain reaction methods. Results: Human metapneumovirus was detected in BAL specimens from 5 of 163 patients (3.0%). Persistent viral infection was noted in 3 patients with several samples, and hMPV was detected in 1 of 2 lung specimens tested. Infected patients became symptomatic within the first 40 days after transplantation. Initial symptoms included fever, cough, nasal congestion, and sore throat. Clinical findings included respiratory failure, pulmonary hemorrhage, and culture-negative septic shock. Four of 5 patients died with acute respiratory failure. Limitations: This retrospective study did not evaluate asymptomatic patients or those with mild disease. Conclusion: Human metapneumovirus infection in the lower respiratory tract is associated with respiratory failure in immunocompromised adults who were previously considered to have "idiopathic pneumonia." The infection may result in fulminant respiratory decompensation and shock after transplantation.
Hemospray in the treatment of upper gastrointestinal hemorrhage in patients on antithrombotic therapy
Authors: I. Holster, E. Kuipers, E. Tjwa
Journal: Endoscopy (2012)

Patients on antithrombotic therapy (ATT) have the highest risk of ongoing bleeding and mortality. Hemospray (Cook Medical, Winston-Salem, North Carolina, USA) is a novel hemostatic agent for the treatment of upper gastrointestinal bleeding (UGIB). Initial reports on its use appear promising in terms of initial hemostasis and rebleeding rates. It is unknown whether this also pertains to patients on ATT. The aim of the current study therefore was to evaluate the efficacy of Hemospray in the treatment of UGIB in patients taking ATTs. A total of 16 unselected consecutive patients with UGIB who were treated with Hemospray were analyzed (eight taking ATT for various indications and eight not on ATT). Initial hemostasis was achieved after Hemospray application in 5 /8 patients on ATT (63 %) and in all eight patients not on therapy (P = 0.20). Rebleeding rates were similar in both groups. These preliminary data on the use of Hemospray in the management of UGIB are promising in both patients with and without ATT; however, caution should be exercised for its use in patients on ATT with spurting arterial bleeding.
Abstract 2660: Prevalence of obesity among subjects with a personal history of cancer: A call for action among cancer survivors and care providers
Authors: Ambria Moten, Kayin Jeffers, Daniel Larbi, Roxanne Smith-White, Teletia Taylor, Lori L. Wilson, Wayne Frederick, Adeyinka O. Laiyemo
Journal: Cancer Research (2012)

Abstract Background: Studies have suggested that obesity is a risk factor for many common cancers and has a negative impact on the prognosis of those with cancer. Aim: To determine the prevalence of overweight and obesity among cancer survivors. Methods: We used the 2007 Health Information National Trends Survey (HINTS) data and identified those with (n = 966) and without (n = 6,093) a personal history of cancer. We calculated responders’ body mass index (BMI) using self-reported height and weight data and formed 3 categories: BMI &amp;lt; 25 kg/m*2 (normal); BMI 25 - 29 kg/m*2 (overweight); and BMI ≤ 30 kg/m*2 (obese). We used multinomial regression models to evaluate the association of personal history of cancer with BMI categories and calculated risk ratios (RR) and 95% confidence interval (CI). Results: The mean age of responders was 54.2 years and 60.5% were females. Cancer survivors were older (65.4 versus 52.4 years; P value &amp;lt;0.001), but there were no differences by sex or education level. After adjusting for age, sex, education, smoking, race, income, marital status and health insurance status, cancer survivors were as likely to be obese as responders without a history of cancer (Table). Conclusion: In this nationally representative sample of US adults, there is a high prevalence of obesity among cancer survivors. Maintenance of healthy weight should be an integral part of routine care of cancer survivors. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 2660. doi:1538-7445.AM2012-2660
Mutation of bcl‐x gene in non‐Hodgkin's lymphoma
Authors: Hiroki Yamaguchi, Koiti Inokuchi, Miki Tarusawa, Kazuo Dan
Journal: American Journal of Hematology (2001)

Abstract The bcl‐x gene product has two forms, bcl‐xl and bcl‐xs. The bcl‐xl form, similar to bcl‐2, inhibits apoptosis. Reverse transcriptase‐‐polymerase chain reaction‐‐single‐stranded conformation polymorphism (RT‐PCR‐SSCP) gel analysis was used to screen for mutations of the bcl‐xl transcript of 50 non‐Hodgkin’s lymphoma (NHL) cases. One missense mutation in a patient with diffuse large B‐cell lymphoma was found. Sequence analysis of this case showed that AGC (Ser) was mutated to GGC (Gly) in codon 154. An examination of mutation and/or polymorphism in born marrow samples of this case and 50 normal controls by the RT‐PCR‐SSCP method could not detect bandshifts. Mutation of the bcl‐x gene in NHL has not been reported previously. There is a possibility that mutation of the bcl‐x gene play a role in the tumorigenesis of NHL. Am. J. Hematol. 69:74‐76, 2002. © 2002 Wiley‐Liss, Inc.
Musculoskeletal Findings in Klippel-Trenaunay Syndrome
Authors: RUTH D. SNOW, MYRON L. LECKLITNER
Journal: Clinical Nuclear Medicine (1991)

Klippel-Trenaunay syndrome is an angio-osteohypertrophy syndrome without deep arteriovenous malformations. Clinical manifestations consist of vascular nevi, varices, and bony and soft-tissue hypertrophy. On skeletal imaging, there was extensive radionuclide uptake in a massively enlarged right lower extremity.