tbuckley/cabot-search huggingface dataset:
Systematic Review: Treatment Agreements and Urine Drug Testing to Reduce Opioid Misuse in Patients With Chronic Pain
Authors: Joanna L. Starrels
Journal: Annals of Internal Medicine (2010)

Experts recommend opioid treatment agreements and urine drug testing to reduce opioid analgesia misuse, but evidence of their effectiveness has not been systematically reviewed.To synthesize studies of the association of treatment agreements and urine drug testing with opioid misuse outcomes in outpatients with chronic noncancer pain.MEDLINE, PsycINFO, EMBASE, Cochrane Central Register of Controlled Clinical Trials (January 1966 to June 2009), reference lists, and expert contacts.Original research addressing opioid medications, chronic pain, and treatment agreements or urine drug testing, with a sample size of 50 participants or more and published in English, Spanish, or French.Two investigators independently identified eligible studies, extracted data, and assessed study quality. The outcome of opioid misuse was defined as drug abuse, drug misuse, aberrant drug-related behavior, diversion, or addiction.Of 102 eligible studies, 11 met inclusion criteria; 6 were in pain clinics and 5 were in primary care settings. Four primary care studies examined multicomponent strategies that included interdisciplinary support. All studies were observational and rated as poor to fair quality. In 4 studies with comparison groups, opioid misuse was modestly reduced (7% to 23%) after treatment agreements with or without urine drug testing. In the other 7 studies, the proportion of patients with opioid misuse after treatment agreements, urine drug testing, or both varied widely (3% to 43%).Diversity of interventions and opioid misuse measures precluded meta-analysis. Most studies evaluated combinations of interventions.Relatively weak evidence supports the effectiveness of opioid treatment agreements and urine drug testing in reducing opioid misuse by patients with chronic pain. Further research on effective ways to monitor and reduce opioid misuse is needed, especially in primary care settings.Substance Abuse and Mental Health Services Administration, National Institute on Drug Abuse, and Robert Wood Johnson Foundation.
Blockade of platelet membrane glycoprotein Ib receptors delays intracoronary thrombogenesis, enhances thrombolysis, and delays coronary artery reocclusion in dogs.
Authors: S K Yao, J C Ober, L I Garfinkel, Y Hagay, N Ezov, J J Ferguson, H V Anderson, A Panet, M Gorecki, L M Buja
Journal: Circulation (1994)

Von Willebrand factor and platelet membrane glycoprotein Ib receptors interact to mediate platelet adhesion and thrombogenesis in stenosed and endothelium-injured arteries. We wished to determine whether blocking glycoprotein Ib receptors with a recombinant von Willibrand factor binding domain (VCL) increases the time required for thrombus formation after injury to the coronary arteries. We also wished to determine whether, after thrombolysis with tissue plasminogen activator (TPA), VCL delays or protects against coronary artery reocclusion. Twenty-seven dogs were treated with either saline, VCL, or aspirin before thrombosis was induced in their coronary arteries by electrical injury. The time from injury to the formation of occlusive thrombi was significantly greater with VCL (70 +/- 10 minutes) and aspirin (69 +/- 20 minutes) than with saline (18 +/- 3 minutes, P &lt; .001 and P &lt; .05). Thrombosis was induced in 30 other dogs that then received thrombolytic treatment in four groups. Our major finding was that coronary artery reocclusion occurred in 72 +/- 11 minutes after treatment with TPA (80 micrograms/kg + 8 micrograms.kg-1.min-1) and heparin (200 U/kg) (n = 7); in 142 +/- 24 minutes after TPA, heparin, and VCL (4 mg/kg + 2 mg.kg-1.h-1) (n = 7) (compared with TPA and heparin, P &lt; .05); in 74 +/- 13 minutes after TPA, heparin, and aspirin (5 mg/kg) (n = 8); and in 173 +/- 8 minutes after TPA, heparin, VCL, and aspirin (n = 8) (compared with TPA and heparin, P &lt; .001). Thus, VCL increases the length of time required for thrombus formation in coronary arteries, and, when given with TPA and heparin, delays coronary artery reocclusion more effectively than aspirin.
Changes in pulmonary function and cross-sectional area of trachea and bronchi in asthmatics following inhalation of procaterol hydrochloride and ipratropium bromide.
Authors: V Hoffstein, N Zamel, P McClean, K R Chapman
Journal: American Journal of Respiratory and Critical Care Medicine (1994)

To determine the sites of action of inhaled adrenergic and anticholinergic bronchodilators, we used the acoustic reflection technique to measure airway area before and after administration of beta 2-selective adrenoreceptor agonist (procaterol hydrochloride) and quaternary anticholinergic agent (ipratropium bromide). Eight stable individuals with asthma (five men and three women; mean age, 34 +/- 12.7 yr) were studied on 2 days in single-blind randomized crossover fashion when they self-administered (using metered-dose inhaler) two puffs of either procaterol hydrochloride hemihydrate (10 micrograms/puff) or ipratropium bromide (20 micrograms/puff). Maximal expiratory flow-volume curve, specific airway resistance, and cross-sectional areas of three airway segments (extrathoracic tracheal, intrathoracic tracheal, and bronchial) were recorded at baseline and 15, 30, 60, and 120 min after drug administration. Both agents produced significant improvements in FEV1, FVC and forced expiratory flow at 50% of vital capacity (V50), and specific airway resistance (SRaw) as early as 15 min after drug administration. These effects were sustained for the 120 min monitoring period. However, all improvements were significantly greater for procaterol than for ipratropium. By contrast, there was no significant difference between drugs in the increased production in the cross-sectional areas of the three airway segments although there was a nonsignificant trend toward greater increases in tracheal area produced by the anticholinergic agent.(ABSTRACT TRUNCATED AT 250 WORDS)
Reliability of mini-bronchoalveolar lavage for the measurement of epithelial lining fluid concentrations of tobramycin in critically ill patients
Authors: Emmanuel Boselli, Dominique Breilh, Sarah Djabarouti, Christian Guillaume, Thomas Rimmelé, Jean-Baptiste Gordien, Fabien Xuereb, Marie-Claude Saux, Bernard Allaouchiche
Journal: Intensive Care Medicine (2007)
International Year of Disabled Persons
Authors: Asa P. Ruskin
Journal: JAMA (1981)

<h3>To the Editor.—</h3> Progressively, over the last few decades, advances in medicine have increased the life expectancy and potential of persons with all varieties of disability. Simultaneously there has been a development of social consciousness and awareness that is spreading over our shrinking planet. The status of the handicapped person must be seen in the overall context of the developing awareness of ourselves as fellow voyagers in the same craft. I believe that they are the same general forces that have produced the development of the third world, an appreciation of the importance of preserving our ecology, and the awesome need to truly appreciate the brotherhood of man that has culminated in our area of interest in the proclamation by the United Nations designating 1981 as the International Year of Disabled Persons. The stated mission of the US Council for the International Year of Disabled Persons is to promote "the
Maternal serum screening for Down's syndrome in early pregnancy.
Authors: N. J. Wald, H. S. Cuckle, J. W. Densem, K. Nanchahal, P. Royston, T. Chard, J. E. Haddow, G. J. Knight, G. E. Palomaki, J. A. Canick
Journal: BMJ (1988)

The possibility of improving the effectiveness of antenatal screening for Down's syndrome by measuring human chorionic gonadotrophin concentrations in maternal serum during the second trimester to select women for diagnostic amniocentesis was examined. The median maternal serum human chorionic gonadotrophin concentration in 77 pregnancies associated with Down's syndrome was twice the median concentration in 385 unaffected pregnancies matched for maternal age, gestational age, and duration of storage of the serum sample. Measuring human chorionic gonadotrophin in maternal serum was an effective screening test, giving a lower false positive rate (3%) at a 30% detection rate than that for maternal age (5%) and the two existing serum screening tests, unconjugated oestriol (7%) and alpha fetoprotein (11%). The most effective screening results were obtained with all four variables combined; at the same 30% detection rate the false positive rate declined to 0.5%. The new screening method would detect over 60% of affected pregnancies, more than double that achievable with the same amniocentesis rate in existing programmes (5%), and could reduce the number of children born with Down's syndrome in the United Kingdom from about 900 a year to about 350 a year.
Antiplatelet Aggregant Agents and Thrombolytic Compounds in Myocardial Infarction: Current Status
Authors: STANFORD WESSLER, LAURENCE A. SHERMAN
Journal: Circulation (1972)

ON MANY FRONTS, both prophylactic and therapeutic, major efforts have been or are about to be undertaken to decrease what some have termed the "epidemic" of coronary artery disease and acute myocardial infarction in our society.The difficulties confronting the clinical investigator who wishes to mount a meaningful therapeutic attack on this problem are great and stem from several sources.Mortality Rate Variations.Institutional mortality rates vary from 10 to 45% among patients hospitalized with acute myocardial infarction.The therapy to be evaluated thus may be significantly affected by the nature of the population tested, as reflected by its mortality rate, and the results obtained may not be applicable to apparently comparable populations in adjacent hospitals or in institu- tions in other cities or countries.Such basic differences in populations are widened still further when investigators increase the selec- tivity of their study populations by establish- ing different diagnostic or other clinical criteria for the inclusion or exclusion from the study of patients purported to have acute myocardial infarction and by employing non- standard treatment criteria for complications such as arrhythmias and heart block.
Rehabilitation Medicine: Principles and Practice
Authors: Sheldon Berrol
Journal: JAMA (1989)

Dr DeLisa and his section editors have produced the most comprehensive text available in the field of physical medicine and rehabilitation. The task established by the authors, to encompass both basic principles and practice techniques in patient management, which is so seldom encountered in a volume of this size, has been admirably achieved. It is most difficult to obtain consistency in style and format in a multidisciplinary, multiauthored text, but the editors have obviously provided expertise and detailed individual counsel to each of the authors. The book is divided into four major categories, "Evaluation," "Diagnosis and Management," "Major Rehabilitation Problems," and "Rehabilitation of Specific Disorders." Each major category is further subdivided into 9 to 16 constituent chapters. This allows for a general overview of principles, such as the chapter on "Rehabilitation of the Pediatric Patient," yet provides specifics of pediatric neurological rehabilitation under "Rehabilitation of Patients With Diseases Affecting the
What the Stethoscope Said
Authors: Bonnie Salomon
Journal: Annals of Internal Medicine (2001)

On Being a Doctor3 July 2001What the Stethoscope SaidBonnie Salomon, MDBonnie Salomon, MDDr. Salomon: Deerfield, IL 60015Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-135-1-200107030-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail You might think it odd to care about a broken stethoscope—a piece of steel and plastic tubing, an instrument, a mere tool. You might think it overly sentimental to care about a 15-year-old stethoscope, now broken, a dud, not able to transmit the harshest breath sounds or murmur. My stethoscope has come to the end of the line, so to speak, lived out its life expectancy perhaps, and no longer works. It's time to get a new one. So why the fuss? Why bother feeling an emotional attachment to this inanimate but intimate object of auscultation?The past few emergency ...Reference1. Walsh JJ. René-Théophile-Hyacinthe Laennec. The Catholic Encyclopedia. Volume VIII. Online Edition, 1999. Available at www.newadvent.org/cathen/08737b.htm Last accessed 25 May 2000. Google Scholar Author, Article, and Disclosure InformationAffiliations: Dr. Salomon: Deerfield, IL 60015Corresponding Author: Bonnie Salomon, MD, 53 Crestview Drive, Deerfield, IL 60015. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoWhat the Stethoscope Said Lee Sataline Metrics Cited byClinical History and Physical ExaminationWhat the Stethoscope SaidLee Sataline, MD 3 July 2001Volume 135, Issue 1Page: 56-57KeywordsAuscultationEmergency departmentEmotionsPneumoniaReflexesResuscitationShockThoraxTongueValvular diseases ePublished: 3 July 2001 Issue Published: 3 July 2001 Copyright & PermissionsCopyright © 2001 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
237 Role of the mitochondrial permeability transition in acetaminophen-induced necrotic and apoptotic cell death to cultured mouse hepatocytes
Authors: K KON, J KIM, E DOYAL, J LEMASTERS
Journal: Hepatology (2003)

Acetaminophen is the leading cause of acute liver failure (ALF) in many countries including the United States. Hepatic glucuronidation by UDP-glucuronosyltransferase (UGT) 1A subfamily enzymes is the major route of acetaminophen elimination. Reduced glucuronidation may predispose some individuals to acetaminophen-induced ALF, but mechanisms underlying reduced glucuronidation are poorly understood. We hypothesized that specific microRNAs (miRNAs) may reduce UGT1A activity by direct effects on the UGT1A 3′-UTR shared by all UGT1A enzyme transcripts, or by indirect effects on transcription factors regulating UGT1A expression. We performed an unbiased miRNA whole transcriptome association analysis using a bank of human livers with known acetaminophen glucuronidation activities. Of 754 miRNAs evaluated, 9 miRNAs were identified that were significantly overexpressed (p < 0.05; >2-fold) in livers with low acetaminophen glucuronidation activities compared with those with high activities. miR-375 showed the highest difference (>10-fold), and was chosen for further mechanistic validation. We demonstrated using in silico analysis and luciferase reporter assays that miR-375 has a unique functional binding site in the 3′-UTR of the aryl hydrocarbon receptor (AhR) gene. Furthermore overexpression of miR-375 in LS180 cells demonstrated significant repression of endogenous AhR protein (by 40%) and mRNA (by 10%), as well as enzyme activity and/or mRNA of AhR regulated enzymes including UGT1A1, UGT1A6, and CYP1A2, without affecting UGT2B7, which is not regulated by AhR. Thus miR-375 is identified as a novel repressor of UGT1A-mediated hepatic acetaminophen glucuronidation through reduced AhR expression, which could predispose some individuals to increased risk for acetaminophen-induced ALF.
Variations in the Use of Chemotherapy for Elderly Patients With Advanced Ovarian Cancer: A Population-Based Study
Authors: V. Sundararajan
Journal: Journal of Clinical Oncology (2002)

PURPOSE: Since 1986, the recommended therapy for patients with ovarian cancer has included surgery and chemotherapy with a platinum compound (cisplatin or carboplatin). The purpose of this study is to assess the use of chemotherapy in elderly patients with advanced ovarian cancer. METHODS: The Surveillance, Epidemiology, and End Results–Medicare database represents approximately 14% of the United States population and provides clinical and demographic information on cancer patients covered by Medicare, along with health care–utilization data from Medicare claims files. We analyzed the association of demographic and clinical factors with treatment among patients diagnosed from 1992 to 1996 with stage III or IV ovarian cancer, who survived ≥ 120 days beyond diagnosis, and were ≥ 65 years of age (N = 1,775). RESULTS: Approximately 83% of elderly patients received some form of chemotherapy within 4 months of diagnosis. In a multiple logistic regression model with patients aged 65 to 69 years as the reference, the odds ratios of receiving chemotherapy were 0.96 (95% confidence interval [CI], 0.63 to 1.46) for ages 70 to 74, 0.65 (95% CI, 0.43 to 1.00) for 75 to 79, 0.24 (95% CI, 0.15 to 0.37) for 80 to 84, and 0.12 (95% CI, 0.07 to 0.19) for 85+. Hispanic patients were less likely to receive chemotherapy than non-Hispanic white patients. Since 1992, paclitaxel has gradually replaced cyclophosphamide as the drug most commonly used with platinum. CONCLUSION: Despite its proven efficacy in treating ovarian cancer, chemotherapy seems to be used less among patients over age 65, especially those who are nonwhite and/or in the oldest age groups. Further research is needed to elucidate to what degree this represents appropriate clinical judgment and to what degree other factors, such as patient choice, play a role.
Abstract 5597: NK cells and CD8+ T cells in orthotopic pancreatic cancer model: Mediation of anti-cancer immune response by 5-fluorouracil and interferon-α
Authors: Hadeel Khallouf, Susanne Serba, Angela Märten, Dirk Jäger, Jan Schmidt
Journal: Cancer Research (2010)

Abstract Pancreatic cancer has the poorest prognosis of all cancers urging the necessity of new therapeutic approaches. Recent clinical data show encouraging results for combining Interferon-α (IFN-α) immunotherapy with 5-Fluorouacil (5-FU) chemotherapy. However, the role of IFN-α in this immunochemotherapy scheme is still elusive. Here we investigate in vivo the relevance of different immune subpopulations in the anti-cancer immune response mediated by IFN-α in combination with 5-FU. Luciferase-transfected Panc02 cells were implanted in the pancreas of C57BL/6 mice. Five days later, mice were treated with 5-FU alone, 5-FU + IFN-α or with a vehicle control. In parallel, CD4+ T cells, CD8+ T cells, and NK cells were depleted by neutralizing antibodies. Depletion of CD11c+ dendritic cells (DCs) was performed using transgenic CD11c. DTR mice. On day 21, mice were sacrificed and tumors were measured and frozen for further immunohistochemical analysis to evaluate the immune cells infiltration. NK cells were isolated and enriched from spleens of mice and their lytic activity was tested against Panc02 cells using a standard chromium release assay. Our data show that treatment with IFN-α + 5-FU has significantly decreased tumor volume in comparison with control or 5-FU treatments. On the other hand, this decrease in tumor volume was remarkably abolished by depleting CD8+ T cells or NK cells. Furthermore, NK cells isolated from spleens of IFN-α + 5-FU treated mice showed enhanced cytotoxicity towards pancreatic cancer cells (Panc02). Meanwhile, studying the role of CD4+ T cells and DCs besides immunohistochemical analysis is still ongoing. To conclude, this study gives more insight about the mechanism of action of INF-α in combination with 5-FU and introduces CD8+ T cells and NK cells as main players in the observed anti-cancer immune response. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 5597.
Computed Tomography of the Whole Body
Authors: Mark J. Goldman
Journal: JAMA (1984)

<i>Computed Tomography of the Whole Body</i>is a two-volume text that is the collaborative effort of more than 50 contributors who have distinguished themselves in the field of computed tomography (CT) since its inception. The first section is a concise but thorough treatment of the general principles and physics of CT. The remainder of the two volumes is divided into sections dealing with virtually every aspect of applications of CT to human anatomy. A brief, final section discusses recent developments in CT and gives a concise discussion of nuclear magnetic resonance. Despite the multiplicity of authors, the text quality is uniformly excellent. Within each anatomic area, there are adequate examples of normal anatomy. Examples of virtually all important pathological entities are illustrated. Correlations with other imaging modalities are provided where helpful. In general, the quality of the illustrations is excellent, although some of the cranial CT images were obviously generated
Stimulation of hypertrophy of cultured neonatal rat heart cells through an alpha 1-adrenergic receptor and induction of beating through an alpha 1- and beta 1-adrenergic receptor interaction. Evidence for independent regulation of growth and beating.
Authors: P Simpson
Journal: Circulation Research (1985)

Catecholamines may be one of the molecular signals linking increased circulatory demand to myocardial hypertrophy, and I have found previously that norepinephrine stimulates hypertrophy of cultured neonatal rat heart muscle cells through an alpha 1-adrenergic receptor. Since catecholamine stimulation of contractility is believed to be under beta-adrenergic control, I asked whether these cultured heart cells had dual pathways regulating growth and contractility through alpha- and beta-adrenergic receptors, respectively. I examined the effect of adrenergic agents on hypertrophy and beating of myocytes in serum-free cultures. Hypertrophy was defined as an increase in myocyte surface area and in cell protein content, measured by a radioisotopic method, and chronotropic activity was examined visually. Norepinephrine and epinephrine were equipotent stimulants of hypertrophy and beating, increasing cell protein and area 1.5- to 2-fold, and the proportion of beating cells from 5% or less to 95%. Response maxima occurred 24-48 hours after exposure, and EC50 were 20-200 nM. Studies with other agonists (phenylephrine, methoxamine, clonidine, isoproterenol, dopamine) and antagonists (prazosin, terazosin, yohimbine, propranolol, betaxolol, ICI 118,551) indicated that hypertrophy was mediated through an alpha 1-adrenergic receptor, whereas the induction of beating required both alpha 1- and beta 1-receptor activation. Hypertrophied cells with minimal beating were produced by alpha-stimulation, alone. In contrast, alpha-plus beta-stimulation in the presence of cycloheximide to inhibit protein synthesis resulted in maximum beating but no hypertrophy. These findings imply that growth and beating can be regulated independently through separate cellular pathways.
Public Solicitation of Organ Donors
Authors: Robert Steinbrook
Journal: New England Journal of Medicine (2005)

During the past half-century, organ donation has been fertile territory for both extraordinary compassion and complex ethical questions. As transplantation has become safer and outcomes have improved, the rules for donation and the fair allocation of organs have struggled to keep pace.In 2004, there were about 27,000 solid-organ transplantations in the United States — nearly 1600 more than there had been in 2003. Yet the demand for organs remains far greater than the supply. As of July 2005, there were about 89,000 people on waiting lists. For the largest group — the 62,500 patients awaiting kidneys — the expectation . . .