tbuckley/cabot-search huggingface dataset:
Effects of Conjugated Equine Estrogens on Breast Cancer and Mammography Screening in Postmenopausal Women With Hysterectomy
Authors: Marcia L. Stefanick, Garnet L. Anderson, Karen L. Margolis, Susan L. Hendrix, Rebecca J. Rodabough, Electra D. Paskett, Dorothy S. Lane, F. Allan Hubbell, Annlouise R. Assaf, Gloria E. Sarto, Robert S. Schenken, Shagufta Yasmeen, Lawrence Lessin, Rowan T. Chlebowski, for the WHI Investigators
Journal: JAMA (2006)

ContextThe Women's Health Initiative Estrogen-Aone trial comparing conjugated equine estrogens (CEE) with placebo was stopped early because of an increased stroke incidence and no reduction in risk of coronary heart disease. Preliminary results suggesting possible reduction in breast cancers warranted more detailed analysis.ObjectiveTo determine the effects of CEE on breast cancers and mammographic findings.Design, Setting, and ParticipantsFollowing breast cancer risk assessment, 10 739 postmenopausal women aged 50 to 79 years with prior hysterectomy were randomized to CEE or placebo at 40 US clinical centers from 1993 through 1998. Mammography screenings and clinical breast examinations were performed at baseline and annually. All breast cancers diagnosed through February 29, 2004, are included.InterventionA dose of 0.625 mg/d of CEE or an identical-appearing placebo.Main Outcome MeasuresBreast cancer incidence, tumor characteristics, and mammogram findings.ResultsAfter a mean (SD) follow-up of 7.1 (1.6) years, the invasive breast cancer hazard ratio (HR) for women assigned to CEE vs placebo was 0.80 (95% confidence interval [CI], 0.62-1.04; P = .09) with annualized rates of 0.28% (104 cases in the CEE group) and 0.34% (133 cases in the placebo group). In exploratory analyses, ductal carcinomas (HR, 0.71; 95% CI, 0.52-0.99) were reduced in the CEE group vs placebo group; however, the test for interaction by tumor type was not significant (P = .054). At 1 year, 9.2% of women in the CEE group had mammograms with abnormalities requiring follow-up vs 5.5% in the placebo group (P&lt;.001), a pattern that continued through the trial to reach a cumulative percentage of 36.2% vs 28.1%, respectively (P&lt;.001); however, this difference was primarily in assessments requiring short interval follow-up.ConclusionsTreatment with CEE alone for 7.1 years does not increase breast cancer incidence in postmenopausal women with prior hysterectomy. However, treatment with CEE increases the frequency of mammography screening requiring short interval follow-up. Initiation of CEE should be based on consideration of the individual woman's potential risks and benefits.Trial Registrationclinicaltrials.gov Identifier: NCT00000611
ACUTE EFFECTS OF THE ADMINISTRATION OF VASOPRESSIN DURING WATER DIURESIS IN THE DOG*
Authors: John R. Jaenike
Journal: Journal of Clinical Investigation (1963)

It is generally accepted that the elaboration of a urine hypertonic to plasma by the mammalian kidney occurs by means of the abstraction of water from the collecting duct lumen into the medullary interstitium (1). The driving force for the movement of water is an osmotic gradient created by the active transport of sodium chloride from the ascending limb of the loop of Henle into the medullary interstitial space, as originally postulated by Wirz (2) and subsequently confirmed by the micropuncture studies of Gottschalk and Mylle (3). By necessity, micropuncture studies are conducted during essentially steady-state conditions. Similarly. urinary concentrating ability is customarily evaluated during the state of hydropenia or at graded levels of osmotic diuresis, but in either case, at maximally effective circulating levels of vasopressin. Few data exist on the precise changes in urinary composition during the achievement of the antidiuretic state. It was postulated that such data might provide further information concerning the role of vasopressin in the renal concentrating process. Consequently, in the present study observations have been made on the urinary changes during the
Ambient ozone concentrations induce airway hyperresponsiveness in some rat strains
Authors: P. Depuydt, G.F. Joos, R.A. Pauwels
Journal: European Respiratory Journal (1999)

Ozone is known to induce airway hyperresponsiveness (AHR) in humans and animals. Previous studies in animals used high exposure levels and reported inconsistent results. The aim of this study was to investigate the effect of a single low-level ozone exposure on different inbred rat strains. Nine rat strains were exposed to 0.05 parts per million (ppm) for 4 h and airway responsiveness to intravenous 5-hydroxytryptamine (HT) examined. Bronchoalveolar lavage fluid (BALF) was examined for the presence of inflammatory cells and markers. Lewis, BDII and Long-Evans rats developed AHR 90 min after ozone exposure, whereas Wistar, Sprague-Dawley, Fisher 344, Brown-Norway, BDE and DA rats did not. Baseline airway responsiveness to 5-HT differed significantly between rat strains, but did not correlate with the presence or absence of ozone-induced AHR. No inflammatory cell influx was found in BALF of any rat strain. In Long-Evans rats, AHR lasted up to 12 h after ozone exposure despite the absence of an inflammatory cell influx or increase in lactate dehydrogenase, alkaline phosphatase or total protein in BALF. In conclusion, exposure to an ambient concentration of ozone induced airway hyperresponsiveness without airway inflammation in some highly inbred rat strains. Genetic factors are likely to account for the observed variability in sensitivity of the airways to ozone.
Pediatric fulminant hepatic failure in endemic areas of hepatitis B infection: 15 years after universal hepatitis B vaccination
Authors: Huey-Ling Chen, Chee-Jen Chang, Man-Shan Kong, Fu-Chen Huang, Hung-Chang Lee, Chieh-Chung Lin, Ching-Chuan Liu, I-Hsien Lee, Tzee-Chung Wu, Shu-Fen Wu, Yen-Hsuan Ni, Hong-Yuan Hsu, Ding-Shinn Chen, Mei-Hwei Chang
Journal: Hepatology (2004)

To investigate the role of hepatitis B virus (HBV) infection in pediatric fulminant hepatic failure (FHF) after the launch of universal HBV vaccination, the authors analyzed the data from patients with FHF collected from a nationwide collaborative study group. Children aged 1 month to 15 years who were diagnosed with FHF (62 males and 33 females) between 1985-1999 were included. HBV infection (hepatitis B surface antigen [HBsAg] and/or immunoglobulin M hepatitis B core antibody [IgM anti-HBc] seropositive) accounted for 46% (43 of 95 cases) of all the cases of FHF. The average annual incidence of FHF in the time period 1985-1999 was 0.053/100,000 in the group of patients ages 1-15 years and 1.29/100,000 in those patients age &lt; 1 year. Approximately 61% (58 of 95 cases) of all FHF cases were infants. The percentage of HBV infection was found to be higher in infants (57%) compared with children ages 1-15 years (27%) ( P = 0.004). The incidence rate ratio of those patients age &lt; 1 year to those ages 1-15 years was 54.2 for HBV-positive FHF and 15.2 for HBV-negative FHF. Maternal HBsAg was found to be positive in 97% of the infants with HBV-positive FHF, and hepatitis B e antigen (HBeAg) was found to be negative in 84% of these infants. Approximately 74% of all HBV-positive FHF patients and 81% of the infantile HBV-positive patients had been vaccinated. In conclusion, within the first 15 years of universal vaccination, HBV was found to rarely cause FHF in children age &gt; 1 year but remained a significant cause of FHF in infants. HBV-positive FHF was prone to develop in infants born to HBeAg-negative, HBsAg-carrier mothers; these infants had not received hepatitis B immunoglobulin according to the vaccination program in place. (Hepatology 2004;39:58-63.)
Pazopanib in Renal Cell Carcinoma
Authors: James E. Ward, Walter M. Stadler
Journal: Clinical Cancer Research (2010)

Pazopanib is an oral, multitargeted tyrosine kinase inhibitor that has been approved by the U.S. Food and Drug Administration for treatment of patients with advanced renal cell cancer on the basis of a randomized, double-blind, placebo-controlled, phase III trial, which showed that once a day dosing of 800 mg of pazopanib resulted in progression free survival of 9.2 months versus 4.2 months (P < 0.0001). Pazopanib thus joins sorafenib and sunitinib as one of the clinically available VEGF receptor (VEGFR)-targeted drugs for the treatment of patients with advanced clear cell renal cell cancer. The mechanism of action, preclinical and clinical data, and a comparison with the other drugs in its class are outlined below.
Potential Drug Interactions and Duplicate Prescriptions Among Cancer Patients
Authors: R. P. Riechelmann, I. F. Tannock, L. Wang, E. D. Saad, N. A. Taback, M. K. Krzyzanowska
Journal: JNCI Journal of the National Cancer Institute (2007)

Cancer patients receive numerous medications, including antineoplastic agents, drugs for supportive care, and medications for comorbid illnesses. Therefore, they are at risk for drug interactions and duplicate prescribing.A questionnaire eliciting information on demographics and medications taken in the previous 4 weeks was given to adult outpatients receiving systemic anticancer therapy for solid tumors. The Drug Interaction Facts software, version 4.0, was used to identify potential drug interactions and to classify them by level of severity (major, moderate, or minor) and the strength of scientific evidence for them (using categories [1-5] of decreasing certainty). Summary statistics and logistic regression were used to analyze the data. All statistical tests were two-sided.The survey was completed by 405 patients. We observed 276 potential drug interactions, and at least one potential interaction was identified in 109 patients (27%; 95% confidence interval [CI] = 23% to 31%). Of the potential interactions, 25 (9%) were classified as major and 211 (77%) as moderate. Nearly half (49%) of potential interactions were supported by level 1 or 2 scientific evidence. Most potential drug interactions (87%) involved non-anticancer agents such as warfarin, antihypertensive drugs, corticosteroids, and anticonvulsants, but some (n = 36, 13%) involved antineoplastic agents. In multivariable analysis, increased risk of receiving drug combinations in which there were potential drug interactions was associated with receipt of increasing numbers of drugs (odds ratio [OR] = 1.4 per additional drug, 95% CI = 1.26 to 1.58, P<.001 from the Wald chi-square test), type of medication (drugs to treat comorbid conditions versus supportive care medications only; OR = 8.6, 95% CI = 2.9 to 25, P<.001), and the presence of brain tumors. Thirty-two (8%) patients were exposed to duplicate medications, most often corticosteroids, proton pump inhibitors, or benzodiazepines.Potential drug interactions were common among cancer patients and most often involved medications to treat comorbid conditions. Duplicate medications were infrequent.
Gemcitabine versus cisplatin, epirubicin, fluorouracil, and gemcitabine in advanced pancreatic cancer: a randomised controlled multicentre phase III trial
Authors: Michele Reni, Stefano Cordio, Carlo Milandri, Paolo Passoni, Elisa Bonetto, Cristina Oliani, Gabriele Luppi, Roberto Nicoletti, Laura Galli, Roberto Bordonaro, Alessandro Passardi, Alessandro Zerbi, Gianpaolo Balzano, Luca Aldrighetti, Carlo Staudacher, Eugenio Villa, Valerio Di Carlo
Journal: The Lancet Oncology (2005)
The American Psychiatric Publishing Textbook of Mood Disordersedited by Dan J. Stein, M.D., Ph.D., David J. Kupfer, M.D., and Alan F. Schatzberg, M.D. Arlington, Va., American Psychiatric Publishing, 2006, 792 pp. $119.00.
Authors: JAMES W. JEFFERSON
Journal: American Journal of Psychiatry (2006)
Nonmyeloablative Allogeneic Hematopoietic Transplantation: A Promising Salvage Therapy for Patients With Non-Hodgkin's Lymphoma Whose Disease Has Failed a Prior Autologous Transplantation
Authors: Maricer P. Escalón, Richard E. Champlin, Rima M. Saliba, Sandra A. Acholonu, Chitra Hosing, Luis Fayad, Sergio Giralt, Naoto T. Ueno, Farzaneh Maadani, Barbara Pro, Michele Donato, Peter McLaughlin, Issa F. Khouri
Journal: Journal of Clinical Oncology (2004)

Purpose Allogeneic transplantation for patients with lymphoma who experience a recurrence after an autologous transplantation has been considered a hazardous therapeutic choice. We investigated the safety and efficacy of nonmyeloablative stem-cell transplantation in these patients. Patients and Methods Patients were required to have chemosensitive or stable disease. Twenty consecutive patients were treated in two sequential trials. Fifteen patients underwent a preparative regimen of fludarabine (30 mg/m 2 daily for 3 days), intravenous cyclophosphamide (750 mg/m 2 daily for 3 days), and rituximab. For the remaining five patients, the conditioning regimen consisted of cisplatin (25 mg/m 2 continuous infusion daily for 4 days), fludarabine (30 mg/m 2 daily for 2 days), and cytarabine (1,000 mg/m 2 daily for 2 days). Tacrolimus and methotrexate were used for graft-versus-host disease prophylaxis. Results All patients experienced engraftment of donor cells. One patient (5%) experienced grade 2 acute graft-versus-host disease, and no patients experienced a higher grade. One patient experienced disease progression at 115 days post-transplantation and responded to donor lymphocyte infusion. The remaining patients remained disease-free. One patient died at 10.5 months from a fungal infection. With a median follow-up time of 25 months, the estimated 3-year current progression-free survival rate was 95%. Conclusion These data suggest that nonmyeloablative allogeneic stem-cell transplantation is an effective option in lymphoma patients with chemosensitive or stable disease who experience disease recurrence following autologous transplantation.
Anti-inflammatory effect of adenovirus-mediated IκBα overexpression in respiratory epithelial cells
Authors: G.Y. Park, S. Lee, K.H. Park, C.T. Lee, Y.W. Kim, S.K. Han, Y.S. Shim, C.G. Yoo
Journal: European Respiratory Journal (2001)

Many studies into basic biological characteristics of inflammation and tissue injury have implicated pro-inflammatory cytokine-mediated tissue injury in the pathogenesis of inflammatory lung diseases. Because transcription of most pro-inflammatory cytokines is dependent on the activation of nuclear factor (NF)-κB, NF-κB could be a good potential target to suppress the cytokine cascade. Cytokine-induced activation of NF-κB requires phosphorylation and subsequent degradation of IκBa. Therefore, the blocking NF-κB activation by IκBα could inhibit the pro-inflammatory cytokine-induced tissue injury. To evaluate whether blocking of NF-κB activation shows an anti-inflammatory effect, this study investigated the effect of adenovirus-mediated overexpression of IκBα super-repressor (IκBα-SR) on the pro-inflammatory cytokine expression in respiratory epithelial cells. The transduction efficiency of adenovirus was &gt;90% in both A549 and NCI-H157 cells. Ad5IκBα-SR-transduced cells expressed high levels of IκBα-SR, which was resistant to tumour necrosis factor (TNF)-;α-;induced degradation. Adenovirus-mediated overexpression of IκBα-SR blocked cytokine-induced nuclear translocation of p65 and NF-κB deoxyribonucleic acid binding activity without affecting total cellular expression level of NF-κB. Ad5IκBα-SR transduction suppressed cytokine-induced interleukin-;8 and TNF-;α expressions at both ribonucleic acid and protein levels. These results suggest that blocking the nuclear factor-κB pathway by adenovirus-mediated overexpression of IκBα-super-repressor shows an effective anti-inflammatory effect in respiratory epithelial cells.
Procedural sedation and analgesia for adults in the emergency department
Authors: P. Atkinson, J. French, C. A. Nice
Journal: BMJ (2014)

A 59 year old woman presents to the emergency department with an isolated anterior dislocation of her left shoulder after a fall. Other than controlled asthma, she is healthy. Her last meal was four hours before the injury. After adequate analgesia using intravenous fentanyl, and despite an initial attempt to reduce her dislocation using relaxation techniques, it becomes evident that she needs sedation to complete the procedure successfully. Patients in the emergency department often need to undergo painful, distressing, or unpleasant diagnostic and therapeutic procedures as part of their care. The use of various analgesic, sedative, and anaesthetic agents has been outlined in several well referenced guidelines.1 2 3 4 The American Society of Anesthesiologists (ASA) describes four levels of non-dissociative sedation—from minimal sedation to general anaesthesia—in addition to dissociative sedation (box).2 In practice, prolonged deep sedation or general anaesthesia is rarely used in the emergency department in the absence of a clinician with appropriate training in anaesthesia. #### Levels of sedation as described by the American Society of Anesthesiologists2 ##### Non-dissociative sedation
Studies on infant diarrhea. II. Absorption of glucose and net fluxes of water and sodium chloride in a segment of the jejunum.
Authors: R Torres-Pinedo, C L Rivera, S Fernández
Journal: Journal of Clinical Investigation (1966)

Increased stool losses of water, solute, and organic acids after the ingestion of milk during acute diarrhea of infancy have been related to impaired absorption of carbohydrate (1).We have observed that the osmolality of diarrheal stool water is usually high during periods of milk intake.Furthermore, we have demonstrated that carbohydrate comprises most of the solute content of the stool water and that there exists a recipro- cal relationship between the concentration of this compound and that of Cl-, Na+, and K+.On the other hand, there is a direct relationship between the concentration of carbohydrate and total or- ganic anions.Similar effects of carbohydrate on stool volume and acidity have been described when specific disaccharidases are deficient (2-9) or when monosaccharide absorption is impaired (10- 13).An obvious assumption is that unabsorbed carbohydrate exerts an osmotic effect in the bowel and constitutes substrate for the generation of organic acids.However, studies directed at veri- fying these assumptions and determining the char- acteristics of these processes at different levels of the small and large bowel have not been per- formed.Our present studies demonstrate that the absorption of glucose by the jejunum is impaired in acute diarrhea of infancy.The studies also show that the associated net movement of fluid into
A New Electrocardiographic Algorithm to Differentiate Upper Loop Re-Entry From Reverse Typical Atrial Flutter
Authors: Yoga Yuniadi, Ching-Tai Tai, Kun-Tai Lee, Bien-Hsien Huang, Yenn-Jiang Lin, Satoshi Higa, Tu-Ying Liu, Jin-Long Huang, Pi-Chang Lee, Shih-Ann Chen
Journal: Journal of the American College of Cardiology (2005)
Catheterization laboratory events and hospital outcome with direct angioplasty for acute myocardial infarction.
Authors: J K Kahn, B D Rutherford, D R McConahay, W L Johnson, L V Giorgi, T M Shimshak, R W Ligon, G O Hartzler
Journal: Circulation (1990)

To assess the safety of direct infarct angioplasty without antecedent thrombolytic therapy, catheterization laboratory and hospital events were assessed in consecutively treated patients with infarctions involving the left anterior descending (n = 100 patients), right (n = 100), and circumflex (n = 50) coronary arteries. The groups of patients were similar for age (left anterior descending coronary artery, 59 years; right coronary artery, 58 years; circumflex coronary artery, 62 years), patients with multivessel disease (left anterior descending coronary artery, 55%; right coronary artery, 55%; circumflex coronary artery, 64%), and patients with initial grade 0/1 antegrade flow (left anterior descending coronary artery, 79%; right coronary artery, 84%; circumflex coronary artery, 90%). Cardiogenic shock was present in eight patients with infarction of the left anterior descending coronary artery, four with infarction of the right coronary artery, and four with infarction of the circumflex coronary artery. Major catheterization laboratory events (cardioversion, cardiopulmonary resuscitation, dopamine or intra-aortic balloon pump support for hypotension, and urgent surgery) occurred in 10 patients with infarction of the left anterior descending coronary artery, eight with infarction of the right coronary artery, and four with infarction of the circumflex coronary artery (16 of 16 shock and six of 234 nonshock patients, p less than 0.001). There was one in-laboratory death (shock patient with infarction of the left anterior descending coronary artery).(ABSTRACT TRUNCATED AT 250 WORDS)
Causes of Maternal Mortality in Japan
Authors: Ken Nagaya
Journal: JAMA (2000)

Japan's maternal mortality rate is higher than that of other developed countries.To identify causes of maternal mortality in Japan, examine attributes of treating facilities associated with maternal mortality, and assess the preventability of such deaths.Cross-sectional study of maternal deaths occurring in Japan between January 1, 1991, and December 31, 1992.Of 230 women who died while pregnant or within 42 days of being pregnant, 197 died in a hospital and had medical records available, 22 died outside of a medical facility, and 11 did not have records available.Maternal mortality rates per 100,000 live births by cause (identified by death certificate review and information from treating physicians or coroners); resources and staffing patterns of facilities where deaths occurred; and preventability of death, as determined by a 42-member panel of medical specialists.Overall maternal mortality was 9.5 per 100,000 births. Hemorrhage was the most common cause of death, occurring in 86 (39%) of 219 women. Seventy-two (37%) of 197 deaths occurring in facilities were deemed preventable and another 32 (16%) possibly preventable. Among deaths that occurred in a medical facility with an obstetrician on duty, the highest rate of preventable deaths (4.09/100,000 live births) occurred in facilities with 1 obstetrician. Among the 72 preventable deaths, 49 were attributed to 1 physician functioning as the obstetrician and anesthetist. While the unpreventable maternal death rate was highest in referral facilities, the preventable maternal death rate was 14 times lower in referral facilities than in transferring facilities.Inadequate obstetric services are associated with maternal mortality in Japan. Reducing single-obstetrician only delivery patterns and establishing regional 24-hour inpatient obstetrics facilities for high-risk cases may reduce maternal mortality in Japan. JAMA. 2000;283:2661-2667.