tbuckley/cabot-search huggingface dataset:
Outcome of depression in later life in primary care: longitudinal cohort study with three years' follow-up
Authors: E Licht-Strunk, H W J Van Marwijk, T Hoekstra, J W R Twisk, M De Haan, A T F Beekman
Journal: BMJ (2009)

<b>Objectives</b> To study the duration of depression, recovery over time, and predictors of prognosis in an older cohort (≥55 years) in primary care. <b>Design</b> Longitudinal cohort study, with three years' follow-up. <b>Setting</b> 32 general practices in West Friesland, the Netherlands. <b>Participants</b> 234 patients aged 55 years or more with a prevalent major depressive disorder. <b>Main outcome measures</b> Depression at baseline and every six months using structured diagnostic interviews (primary care evaluation of mental disorders according to diagnoses in <i>Diagnostic and Statistical Manual of Mental Disorders</i>, fourth edition) and a measure of severity of symptoms (Montgomery Åsberg depression rating scale). The main outcome measures were time to recovery and the likelihood of recovery at different time points. Multivariable analyses were used to identify variables predicting prognosis. <b>Results</b> The median duration of a major depressive episode was 18.0 months (95% confidence interval 12.8 to 23.1). 35% of depressed patients recovered within one year, 60% within two years, and 68% within three years. A poor outcome was associated with severity of depression at baseline, a family history of depression, and poorer physical functioning. During follow-up functional status remained limited in patients with chronic depression but not in those who had recovered. <b>Conclusion</b> Depression among patients aged 55 years or more in primary care has a poor prognosis. Using readily available prognostic factors (for example, severity of the index episode, a family history of depression, and functional decline) could help direct treatment to those at highest risk of a poor prognosis.
Variation of PDGF, TGFβ, and bFGF levels in essential thrombocythemia patients treated with anagrelide
Authors: P.R. Lev, R.F. Marta, P. Vassallu, F.C. Molinas
Journal: American Journal of Hematology (2002)

Abstract We studied 15 patients with essential thrombocythemia (ET) before treatment and after normalization of platelet count by anagrelide. Significantly increased plasma levels of PDGF, TGFβ, and bFGF were found. Patients with mild reticulin fibrosis in bone marrow had higher PDGF levels. During treatment, plasma TGFβ and bFGF levels remained elevated in most patients ( P &lt; 0.0001 and P &lt; 0.01, respectively). Intraplatelet PDGF levels were low before treatment ( P &lt; 0.006) and normal on hematological remission, without relation with the presence or absence of reticulin fibrosis in bone marrow. Intraplatelet TGFβ levels were normal regardless of the platelet count. Intraplatelet bFGF levels were raised before ( P &lt; 0.001) and during treatment ( P &lt; 0.01). By immunostaining, TGFβ and bFGF were seen in megakaryocytes and lymphocytes with a similar pattern of intensity in patients and controls, suggesting that other cells might also contribute to the raised plasma values. We believe that the plasma increment of these cytokines suggests that they play a role in the pathogenesis of ET. The normal PDGF plasma level found during treatment may be in relation with the platelet count. However, the persistent increase of TGF‐β in plasma and bFGF both in plasma and platelets may indicate dysregulation of cytokine synthesis in TE. Am. J. Hematol. 70:85–91, 2002. © 2002 Wiley‐Liss, Inc.
The effect of micropores in the surface of temperature-responsive culture inserts on the fabrication of transplantable canine oral mucosal epithelial cell sheets
Authors: Daisuke Murakami, Masayuki Yamato, Kohji Nishida, Takeshi Ohki, Ryo Takagi, Joseph Yang, Hideo Namiki, Teruo Okano
Journal: Biomaterials (2006)
Antisense Gene Therapy of Brain Cancer with an Artificial Virus Gene Delivery System
Authors: Yun Zhang, Chunni Zhu, William M. Pardridge
Journal: Molecular Therapy (2002)

Therapeutic genes are delivered to the nuclear compartment of cancer cells following intravenous administration with a non-immunogenic "artificial virus" gene delivery system that uses receptor-specific monoclonal antibodies (MAb) to navigate the biological barriers between the blood and the nucleus of the cancer cell. Mice implanted with intracranial U87 human glial brain tumors are treated with a nonviral expression plasmid encoding antisense mRNA against the human epidermal growth factor receptor gene (EGFR). The plasmid DNA is packaged within the interior of polyethylene glycol-modified (PEGylated) immunoliposomes, and delivered to the brain tumor with MAbs that target the mouse transferrin receptor (TRFR) and the human insulin receptor (INSR). The mouse TRFR MAb enables transport across the tumor vasculature, which is of mouse brain origin, and the INSR MAb causes transport across the plasma membrane and the nuclear membrane of the human brain cancer cell. The lifespan of the mice treated weekly with an intravenous administration of the EGFR antisense gene therapy packaged within the artificial virus is increased 100% relative to mice treated either with a luciferase gene or with saline.
Book Review Richard Bright 1789-1858: Physician in an Age of Revolution and Reform (Eponymists in Medicine.) by Diana Berry and Campbell Mackenzie. 296 pp., illustrated. London, Royal Society of Medicine Services, 1992. £12.95 (cloth); £7.95 (paper). 1-85315-187-4
Authors: Leon G. Fine, Jennifer A. English
Journal: New England Journal of Medicine (1993)
Approval of inhaled insulin in Europe and United States
Authors: Bruce Charlesworth
Journal: BMJ (2006)

Ramifications of screening for breast cancerSee Research p 689 in 4 cancers detected by mammography are pseudocancersEditor-In this issue Zackrisson et al report on follow-up data from the Malmö mammographic screening trial and conclude that the rate of overdiagnosis of breast cancer was 10%. 1 They do not, however, calculate the risk we believe is most relevant to women considering mammography: What is the chance that a screen detected cancer represents overdiagnosis?After 15 years of follow-up, there were 1320 diagnosed in the screened group and 1205 in the control group (table 1).The excess detection of 115 cancers associated with screening led to their conclusion of an overdiagnosis rate of 10% (115/1205).However, because the intervention had stopped 15 years earlier and yet breast cancer cases continue to accumulate in both groups, the approach understates the risk of overdiagnosis.A more relevant denominator is the number of cancers found in the screened group at the end of the trial-741 (table 2).This addresses the question: Were I found to have cancer after being randomised to screening, how likely is it to represent overdiagnosis?As shown in the figure, using this denominator the risk of overdiagnosis is 15% (115/741).However, many of the cancers detected in the screened group are not detected by screening.They are instead clinically detected (either during the interval between screening examinations or among nonattenders).The most relevant denominator is the number of screen detected cancers found at the end of the trial.This addresses the question: Were I found to have cancer by a mammogram, how likely is it to represent overdiagnosis?Although this denominator is not reported by Zackrisson et al, the original BMJ article describing Malmö reported that 64% of the cancers detected in the screened group were detected by screening mammography. 2Thus one can deduce that the number of screen detected cancers at the end of the trial was about 475.As shown in the figure, using this denominator the risk of overdiagnosis is 24% (115/475).
Breast Cancer Treated With Fluorouracil
Authors: Robert J. Samp
Journal: JAMA (1966)

The addition of fluorouracil (5-FU) to standard, palliative antitumor measures for 144 female patients with breast cancer in advanced stages resulted in an average increased survival of 6 to 17 months when compared by subgroups with 127 control cases on standard therapy only during the period immediately preceding the introduction of fluorouracil chemotherapy. All cases have confirmed tissue diagnosis of breast cancer and complete follow-up data. Comparison of survival by subgroups according to age, cancer-free interval between initial therapy and recurrence, sites of metastases, menopausal "age" at the time of dissemination, 50% survival points, and combinations of these significantly favors patients treated with fluorouracil. Furthermore, the use of fluorouracil does not preclude nor contraindicate other and further therapies if and when the tumor reactivates, because further survival time is possible after fluorouracil therapy.
Advance directives about medical treatment.
Authors: T. Hope
Journal: BMJ (1992)

fundholding.Fundholders may decide that it is in their interests to form purchasing consortiums -indeed some have already done so.If the consortiums grow in size they will require some form of bureaucratic organisation.The flexi- bilities of small scale purchasing may then be lost.It is important to remember that the scheme currently covers only one fifth of the total hospital and community service costs for a practice population: currently all emergency attendances and admissions are excluded, as are medical and psychiatric admissions and community and maternity services.Health authorities have to buy these services for their resident populations, including the patients of fundholders.This entails measuring needs and outcomes, identifying possibilities for health gains, and setting priori- ties.The skills required to perform these tasks are rarely found in primary care.Fundholding remains an interesting experiment, which should continue as long as there is a commitment to monitor and learn from the experience.But we have not arrived at the point where general practitioners should take over as the main purchasers of health care.
Faculty Practice Plans: Caring for the Underserved?-Reply
Authors: Roger J. Bulger
Journal: JAMA (1993)

<h3>In Reply.</h3> —I am delighted with Dr Retchin's letter and agree with the thrust of his comments about the potential of FPPs to be valuable instruments in facilitating care to the chronically underserved, once financial access to care is provided through health care reform. At that point, patient care dollars will become available for services rendered to patients who previously could not pay. Most of us do not believe that financial reform will be sufficient to bring competing organized provision systems into remote rural or dangerous inner-city underserved settings. The existence of a physician practice plan could certainly allow for the hiring of the physicians, nurse practitioners, and physician assistants likely to be necessary to provide basic ambulatory care to the population of an area. Furthermore, the specialty physician backup, available through the medical school practice plan, could smoothly assist the primary care providers as required. It would be splendid
Influence of male hormones on rates of ethanol elimination in man
Authors: Esteban Mezey, Joseph E. Oesterling, James J. Potter
Journal: Hepatology (1988)

The effect of a reduction in androgens on ethanol elimination was determined in man. Bilateral therapeutic orchiectomy in nine patients for prostatic carcinoma decreased mean plasma testosterone levels from 489.8 ± 31.2 (S.E.) ng per dl to 55.3 ± 3.8 ng per dl and resulted in an increase in the rate of ethanol elimination in seven patients, no change in one, and a decrease in one. The mean rate of ethanol elimination for all nine patients increased from 83.6 ± 4.0 to 100.4 ± 4.2 mg per kg body weight per hr (p &lt; 0.02). The most likely mechanism for an increase in ethanol elimination after orchiectomy is an increase in liver alcohol dehydrogenase content, which remains to be demonstrated in man.
In vitro comparison of the molecular adsorbent recirculation system (MARS) and single-pass albumin dialysis (SPAD)
Authors: Igor M. Sauer, Max Goetz, Ingo Steffen, Gesa Walter, Daniel C. Kehr, Ruth Schwartlander, Yoon J. Hwang, Andreas Pascher, Joerg C. Gerlach, Peter Neuhaus
Journal: Hepatology (2004)

The detoxification capacities of single-pass albumin dialysis (SPAD), the molecular adsorbents recirculation system, (MARS) and continuous veno-venous hemodiafiltration (CVVHDF) were compared in vitro . In each experiment 4,100 mL of toxin-loaded human plasma was processed for 6.5 hours. MARS treatment (n = 6) was undertaken in combination with CVVHDF. For SPAD (n = 6) and CVVHDF (n = 6) a high-flux hollow fiber hemodiafilter (identical to the MARS filter) was used. Levels of ammonia, urea, creatinine, bilirubin, and bile acids were determined. Concentrations before and after application of detoxification procedures were expressed as differences and were compared using the Kruskal-Wallis test. Post hoc comparisons for pairs of groups were adjusted according to Bonferroni-Holm. Time, group, and interaction effects were tested using the nonparametric ANOVA model for repeated measurements. SPAD and CVVHDF induced a significantly greater reduction of ammonia levels than MARS. No significant differences were found among SPAD, MARS, and CVVHDF with respect to other water-soluble substances. SPAD induced a significantly greater reduction in bilirubin levels than MARS. Reductions in bile acid levels were similar for SPAD and MARS. When operating MARS in continuous veno-venous hemodialysis mode, as recommended by the manufacturer, no significant differences in the removal of bilirubin, bile acids, urea, and creatinine were found. However, MARS in continuous veno-venous hemodialysis mode was significantly less efficient in removing ammonia than MARS in CVVHDF mode. In conclusion, the detoxification capacity of SPAD is similar to or even greater than that of MARS. (Hepatology 2004;39:1408-1414.)
THE EFFECTS OF MODERN DRESS ON THE HEALTH OF WOMEN.Read before the Indiana State Medical Society, Indianapolis, Ind., May 17, 1894.
Authors: MARTHA J. SMITH
Journal: JAMA (1894)

Every woman's dress expresses, not only some of her own individuality, but it expresses even more, her unity with the race; the common history and status of her sex. Of all nations of the earth we suffer most from the cruel tyrannies of dress. American women are known abroad for two distinguishing traits (besides possibly their beauty and self-reliance),and these are their ill health and extravagant devotion to dress. We strike the sturdy German and English matrons with dismay. Without the trailing skirt of a year ago we were told we were bereft of our grace, our loveliness, our womanliness. Men are excellent theorizers upon the absurdities of modern dress, but when a practical application of their theories is made by their wives and daughters or sisters, few are found brave enough to stand by and encourage them to wear only such garments as are conducive to their health and
T Helper 17 Lineage Differentiation Is Programmed by Orphan Nuclear Receptors RORα and RORγ
Authors: Xuexian O. Yang, Bhanu P. Pappu, Roza Nurieva, Askar Akimzhanov, Hong Soon Kang, Yeonseok Chung, Li Ma, Bhavin Shah, Athanasia D. Panopoulos, Kimberly S. Schluns, Stephanie S. Watowich, Qiang Tian, Anton M. Jetten, Chen Dong
Journal: Immunity (2008)
A ThPOK-LRF transcriptional node maintains the integrity and effector potential of post-thymic CD4+ T cells
Authors: Melanie S Vacchio, Lie Wang, Nicolas Bouladoux, Andrea C Carpenter, Yumei Xiong, Linus C Williams, Elizabeth Wohlfert, Ki-Duk Song, Yasmine Belkaid, Paul E Love, Rémy Bosselut
Journal: Nature Immunology (2014)
Long-term effects of azathioprine in rheumatoid arthritis.
Authors: M B Urowitz, H A Smythe, T Able, C S Norman, C Travis
Journal: Annals of the Rheumatic Diseases (1982)

Efficacy and safety of azathioprine in 9high9 and 9low9 dose regimens in rheumatoid arthritis (RA), both in short-term studies and in follow-up over 40 months, have previously been shown. In the present report, 36 patients with RA treated with azathioprine (group I) and 49 age-matched patients with RA (group II), were studied to detect potential early markers of malignancy. Chest x-rays were similar to both groups. One patient in group I had a positive PAP smear and was subsequently found to have uterine carcinoma. Alpha-fetoprotein was positive in one patient in group I and none in group II. CEA was negative in all patients in group I, but positive in seven in group II. On chromosomal analysis group I showed a greater frequency of breakage. Group I showed lower serum folates and a highly significant number of megaloblastic features in marrow aspirates. In group I seven tumours, three being malignant, occurred while taking azathioprine, and in group II six tumours, one malignant, were identified (p = 0.17). The apparent increased risk of malignancy previously suggested by others warrants further studies with larger populations and over a continuous longer period.
579 Effectiveness of antiviral therapy in patients with chronic hepatitis C treated by gastroenterologists in private practice
Authors: W.P. Hofmann, H. Bock, C. Weber, W. Tacket, R. Pfaff, R. Kihn, G. Moog, H.U. Kellner, M. Schöfer, B. Frick, P. Berge, A. Rambow, M. Friedrich-Rust, E. Herrmann, C. Sarrazin, S. Zeuzem
Journal: Journal of Hepatology (2006)
INCREASED REFERENCE AND ABSOLUTE CORONARY FLOW RESERVE AFTER PRIMARY PERCUTANEOUS CORONARY INTERVENTION FOR A FIRST ACUTE ANTERIOR MYOCARDIAL INFARCTION ARE ASSOCIATED WITH SURVIVAL AT 10 YEARS FOLLOW-UP
Authors: Matthijs Bax, Martijn Meuwissen, Tim van de Hoef, Robbert J. de Winter, Karel T. Koch, Jan GP Tijssen, Ronak Delewi, Carl E. Schotborgh, Jose PS Henriques, Jan J. Piek
Journal: Journal of the American College of Cardiology (2011)
Effectiveness and Limitations of β-Blocker Therapy in Congenital Long-QT Syndrome
Authors: Arthur J. Moss, Wojciech Zareba, W. Jackson Hall, Peter J. Schwartz, Richard S. Crampton, Jesaia Benhorin, G. Michael Vincent, Emanuela H. Locati, Silvia G. Priori, Carlo Napolitano, Aharon Medina, Li Zhang, Jennifer L. Robinson, Katherine Timothy, Jeffrey A. Towbin, Mark L. Andrews
Journal: Circulation (2000)

Background —β-blockers are routinely prescribed in congenital long-QT syndrome (LQTS), but the effectiveness and limitations of β-blockers in this disorder have not been evaluated. Methods and Results —The study population comprised 869 LQTS patients treated with β-blockers. Effectiveness of β-blockers was analyzed during matched periods before and after starting β-blocker therapy, and by survivorship methods to determine factors associated with cardiac events while on prescribed β-blockers. After initiation of β-blockers, there was a significant ( P &lt;0.001) reduction in the rate of cardiac events in probands (0.97±1.42 to 0.31±0.86 events per year) and in affected family members (0.26±0.84 to 0.15±0.69 events per year) during 5-year matched periods. On-therapy survivorship analyses revealed that patients with cardiac symptoms before β-blockers (n=598) had a hazard ratio of 5.8 (95% CI, 3.7 to 9.1) for recurrent cardiac events (syncope, aborted cardiac arrest, or death) during β-blocker therapy compared with asymptomatic patients; 32% of these symptomatic patients will have another cardiac event within 5 years while on prescribed β-blockers. Patients with a history of aborted cardiac arrest before starting β-blockers (n=113) had a hazard ratio of 12.9 (95% CI, 4.7 to 35.5) for aborted cardiac arrest or death while on prescribed β-blockers compared with asymptomatic patients; 14% of these patients will have another arrest (aborted or fatal) within 5 years on β-blockers. Conclusions —β-blockers are associated with a significant reduction in cardiac events in LQTS patients. However, syncope, aborted cardiac arrest, and LQTS-related death continue to occur while patients are on prescribed β-blockers, particularly in those who were symptomatic before starting this therapy.
Dietary Nitrate: Ward et al. Respond
Authors: Mary H. Ward, Theo M. de Kok, Patrick Levallois, Jean Brender, Gabriel Gulis, James VanDerslice, Bernard T. Nolan
Journal: Environmental Health Perspectives (2006)

Manganese as a Potential Confounder of Serum Prolactinde Burbure et al. (2006) elegantly demonstrated that dopaminergic markers in the serum, namely prolactin and homovanillic acid, are affected in children exposed to cadmium, lead, mercury, and arsenic.These findings, at low environmental exposure levels, reinforce the potential of these metals to perturb dopaminergic function and optimal development.In spite of the strengths of the article, de Burbure et al. (2006) overlooked an important potential confounder.Specifically, the authors should consider the possibility that manganese confounded their data; if so, the data set should be reexamined.A strong relationship between manganese exposure and serum prolactin levels has been raised in multiple studies.Although prolactin levels serve as a direct measurement of monoamines or their metabolites in peripheral tissues (e.g., blood platelets, plasma, urine), plasma prolactin is also an indirect indicator of dopaminergic functioning, a target for excessive exposure to manganese (Mutti and Smargiassi 1998;Smargiassi and Mutti 1999).A concordance between neurocognitive deficits and manganese exposure also exists, including a recent study in children exposed to water manganese concentrations exceeding 300 µg/L (Wasserman et al. 2006).A significant and positive correlation between blood manganese concentrations and prolactin levels in cord blood has also been established (Tasker et al. 2004).Other examples abound, although negative relationships between manganese and prolactin have also been reported (Roels et al. 1992).The potential that exposure to manganese contributed to or confounded the effects of the four metals on serum prolactin levels in the cohorts studied by de Burbue et al. (2006) should be considered.If samples are available for additional analysis, correlations between manganese exposure and prolactin would be beneficial and welcomed by various health forums as the debate on safe manganese exposure levels and sensitive health effect biomarkers continues.
Effects of the Prostaglandins on Hormone-induced Mobilization of Free Fatty Acids *
Authors: Daniel Steinberg, Martha Vaughan, Paul J. Nestel, Ove Strand, Sune Bergström
Journal: Journal of Clinical Investigation (1964)

About 30 years ago, Goldblatt (1, 2) and von Euler (3, 4) showed that human and ovine seminal plasma contain an acidic lipid (prostaglandin) with vasodepressor activity and smooth muscle-stimu- lating activity.The early studies have been sum- marized by von Euler (5, 6).In 1960 Berg- strom and Sjdvall isolated from sheep vesicular glands a highly potent crystalline material, prostaglandin E1 (PGE1) (7).1 The structure of this compound (Figure 1) was established as 2 (6-carboxyhexyl) -3-(3-hydroxyocten-1-yl) -4-hydroxy- cylopentanone (8) or 11a, 15-dihydroxy-9-ketoprost-13-enoic acid.Further studies showed that