tbuckley/cabot-search huggingface dataset:
Propofol versus combined sedation in flexible bronchoscopy: a randomised non-inferiority trial
Authors: D. Stolz, G. Kurer, A. Meyer, P. N. Chhajed, E. Pflimlin, W. Strobel, M. Tamm
Journal: European Respiratory Journal (2009)

Combined sedation with a benzodiazepine and an opiate has been proposed as standard sedation for bronchoscopy. Propofol is a sedative–hypnotic with a rapid onset of action and fast recovery time, but carries the potential risk of respiratory failure. Consecutive patients (n = 200) were randomly allocated to receive either the combination midazolam and hydrocodone or intravenous propofol. The primary end-points were the mean lowest arterial oxygen saturation during bronchoscopy and the readiness-for-discharge score 1 h after the procedure. The mean lowest arterial oxygen saturation during bronchoscopy did not differ across treatment groups (p = 0.422), and the number of patients recording an arterial oxygen saturation of ≤90% on at least one occasion was similar in both groups (p = 0.273). The median (interquartile range) readiness-for-discharge score 1 h after the procedure was significantly higher in the propofol group than in the combined sedation group (8 (6–9) <i>versus</i> 7 (5–9); p = 0.035). Patients assigned propofol exhibited less tachycardia during bronchoscopy and for ≥1 h after the examination. Minor procedural complications were noted in 71 (35.5%) patients and exhibited a similar incidence in both treatment arms (p = 0.460). Propofol is as effective and safe as combined sedation in patients undergoing flexible bronchoscopy, thus representing an appealing option if timely discharge is a priority.
Posterior reversible encephalopathy syndrome in (low renin) essential hypertension
Authors: C M Everett, B Turner, M Lobo
Journal: Journal of the Royal Society of Medicine (2007)

Physicians still encounter hypertensive crises, which merit rapid diagnosis and treatment. Posterior reversible encephalopathy syndrome (PRES) is usually associated with acute changes in blood pressure in patients with complex medical problems. We present the case of a patient with PRES as a presenting feature of essential hypertension.
Plasminogen-Activator Inhibitor Type 1 and Coronary Artery Disease
Authors: Hans P. Kohler, Peter J. Grant
Journal: New England Journal of Medicine (2000)

The development of coronary artery disease, and specifically myocardial infarction, involves hyperplasia of arterial smooth muscle, the development of fatty streaks, atheroma formation, plaque rupture, and ultimately thrombus formation and vessel occlusion.1 These changes are in part genetically determined, as demonstrated by the fact that the risk of myocardial infarction in persons who have a first-degree relative with myocardial infarction is seven times the risk in persons who do not.2,3 This finding is often used to argue that coronary artery disease has a genetic basis, but the extent to which a shared environment contributes to the risk must also . . .
A Multicenter Phase I Gene Therapy Clinical Trial Involving Intraperitoneal Administration of E1A-Lipid Complex in Patients with Recurrent Epithelial Ovarian Cancer Overexpressing HER-2/<b> <i>neu</i> </b> Oncogene
Authors: Srinivasan Madhusudan, Ayala Tamir, Nicholas Bates, Elizabeth Flanagan, Martin E. Gore, Desmond P. J. Barton, Peter Harper, Michael Seckl, Hilary Thomas, Nicholas R. Lemoine, Mark Charnock, Nagy A. Habib, Robert Lechler, Joanna Nicholls, Massimo Pignatelli, Trivadi S. Ganesan
Journal: Clinical Cancer Research (2004)

Abstract Purpose: HER-2/neu oncogene is overexpressed in 10–30% of epithelial ovarian cancers and is associated with a poor prognosis. The E1A gene product of adenovirus type 5 down-regulates HER-2/neu and causes tumor regression in animal models. In the current study, we sought to determine the toxicity and biological activity of E1A-lipid complex in ovarian cancer patients. Experimental Design: A Phase I trial involving intraperitoneal (i.p.) administration of E1A-lipid complex was initiated in ovarian cancer patients to assess biological activity (E1A gene transfer/transcription/translation and HER-2/neu expression) and to determine the maximum tolerated dose. Successive cohorts received E1A-lipid complex at doses of 1.8, 3.6, and 7.2 mg DNA/m2, given as weekly i.p. infusions for 3 of 4 weeks (each cycle) up to a maximum of six cycles. Peritoneal fluid was sampled at baseline and twice monthly for cellularity, cytology, CA-125, and biological activity Results: Fifteen patients, with a median age of 57 years (range, 43–81) were recruited. Three (1.8 mg DNA/m2), 4 (3.6 mg DNA/m2), and 8 patients (7.2 mg DNA/m2) received i.p. E1A. A total of 91 infusions (range, 1–18) was administered. Abdominal pain was the dose-limiting toxicity, and the maximum-tolerated dose was 3.6 mg DNA/m2. E1A gene transfer and expression was observed in all of the patients and at all of the dose levels. HER-2/neu down-regulation could be demonstrated in the tumor cells of 2 patients (18%). There was no correlation between dose and biological activity. Conclusions: I.P. EIA-lipid complex gene therapy is feasible and safe. Future studies, either alone or in combination with chemotherapy, particularly in patients with minimal residual disease, should be evaluated.
Sub-acute occupational hypersensitivity pneumonitis due to low-level exposure to diisocyanates in a secretary
Authors: J. Schreiber, J. Knolle, J. Sennekamp, K. T. Schulz, J. U. Hahn, K. G. Hering, M. Raulf-Heimsoth, R. Merget
Journal: European Respiratory Journal (2008)

There is virtually no information in the literature about the exposure levels needed to induce hypersensitivity pneumonitis (HP) by diisocyanates. The present study reports a case of occupational HP due to diisocyanates after low-level exposure. A 53-yr-old female never-smoker developed progressive shortness of breath on exertion, cough, fatigue and flu-like symptoms shortly after she began work as a secretary of a car body repair shop. A diagnosis of HP was made 2 yrs later, based on a restrictive ventilatory defect, a reticulonodular and discrete ground-glass pattern on high-resolution computed tomography, lymphocytosis in bronchoalveolar lavage and specific immunoglobulin G antibodies to diisocyanate human serum albumin conjugates in the patient’s serum. The diagnosis was confirmed by recovery after exposure cessation and deterioration after re-exposure. Ambient monitoring revealed air concentrations of different diisocyanate monomers below the detection limit in both the patient’s work station and in front of the paint spray booths, with the exception of one measurement that showed 4,4-methylenediphenyl diisocyanate concentrations of 3 µg·m −3 in front of one booth (corresponding to a total reactive isocyanate group concentration of 1 µg·m −3 ). The present authors conclude that concentrations of diisocyanates far below current exposure limits may induce hypersensitivity pneumonitis in susceptible subjects.
Phenotypic and Functional Analysis of Dendritic Cells and Clinical Outcome in Patients With High-Risk Melanoma Treated With Adjuvant Granulocyte Macrophage Colony-Stimulating Factor
Authors: Adil I. Daud, Noweeda Mirza, Brianna Lenox, Stephanie Andrews, Patricia Urbas, Gui X. Gao, Ji-Hyun Lee, Vernon K. Sondak, Adam I. Riker, Ronald C. DeConti, Dmitry Gabrilovich
Journal: Journal of Clinical Oncology (2008)

Granulocyte macrophage colony-stimulating factor (GM-CSF) can induce differentiation of dendritic cells (DCs) in preclinical models. We hypothesized that GM-CSF-stimulated DC differentiation may result in clinical benefit in patients with high-risk melanoma.We conducted a prospective trial in patients with high-risk (stage III B/C, IV), resected melanoma, with GM-CSF 125 microg/m(2)/d administered for 14 days every 28 days. Patients underwent clinical restaging every four cycles, with DC analysis performed at baseline and at 2, 4, 8, and 12 weeks.Of 42 patients enrolled, 39 were assessable for clinical outcome and DC analysis. Median overall survival was 65 months (95% CI, 43 to 67 months) and recurrence-free survival was 5.6 months (95% CI, 3 to 11 months). GM-CSF treatment caused an increase in mature DCs, first identified after 2 weeks of treatment, normalizing by 4 weeks. Patients with decreased DCs at baseline had significant increases in DC number and function compared with those with "normal" parameters at baseline. No change was observed in the number of myeloid-derived suppressor cells (MDSCs). Early recurrence (< 90 days) correlated with a decreased effect of GM-CSF on host DCs, compared with late or no (evidence of) recurrence.GM-CSF treatment was associated with a transient increase in mature DCs, but not MDSCs. Greater increase of DCs was associated with remission or delayed recurrence. The prolonged overall survival observed warrants further exploration.
Quality of Life of Patients With Endometrial Cancer Undergoing Laparoscopic International Federation of Gynecology and Obstetrics Staging Compared With Laparotomy: A Gynecologic Oncology Group Study
Authors: Alice B. Kornblith, Helen Q. Huang, Joan L. Walker, Nick M. Spirtos, Jacob Rotmensch, David Cella
Journal: Journal of Clinical Oncology (2009)

The study's objective was to compare the quality of life (QoL) of patients with endometrial cancer undergoing surgical staging via laparoscopy versus laparotomy.The first 802 eligible patients (laparoscopy, n = 535; laparotomy, n = 267) participated in the QoL study in a Gynecologic Oncology Group (GOG) randomized trial of laparoscopy versus laparotomy (GOG 2222). Patients completed QoL assessments at baseline; at 1, 3, and 6 weeks; and at 6 months postsurgery.In an intent-to-treat analysis, laparoscopy patients reported significantly higher Functional Assessment of Cancer Therapy-General (FACT-G) scores (P = .001), better physical functioning (P = .006), better body image (BI; P < .001), less pain (P < .001) and its interference with QoL (P < .001), and an earlier resumption of normal activities (P = .003) and return to work (P = .04) over the 6-week postsurgery period, as compared with laparotomy patients. However, the differences in BI and return to work between groups were modest, and the adjusted FACT-G scores did not meet the minimally important difference (MID) between the two surgical arms over 6 weeks. By 6 months, except for better BI in laparoscopy patients (P < .001), the difference in QoL between the two surgical techniques was not statistically significant.Although the FACT-G did not show a MID between the two surgical groups, and only modest differences in return to work and BI were found between the two groups, statistically significantly better QoL across many parameters in the laparoscopy arm at 6 weeks provides modest support for the QoL advantage of using laparoscopy to stage patients with early endometrial cancer.
IL-12p40 and IL-18 in Crescentic Glomerulonephritis
Authors: A. Richard Kitching, Amanda L. Turner, Gabrielle R.A. Wilson, Timothy Semple, Dragana Odobasic, Jennifer R. Timoshanko, Kim M. O’Sullivan, Peter G. Tipping, Kiyoshi Takeda, Shizuo Akira, Stephen R Holdsworth
Journal: Journal of the American Society of Nephrology (2005)

Experimental crescentic glomerulonephritis (GN) is characterized by T helper 1 (Th1) directed nephritogenic immune responses and cell-mediated glomerular injury. IL-12p40, the common cytokine chain for both IL-12 and IL-23, is important in the generation and potentially the maintenance of Th1 responses, whereas IL-18 is a co-factor for Th1 responses that may have systemic and local proinflammatory effects. For testing the hypothesis that both endogenous IL-12p40 and endogenous IL-18 play pathogenetic roles in crescentic GN, accelerated anti-glomerular basement membrane GN was induced in mice genetically deficient in IL-12p40 (IL-12p40-/-), IL-18 (IL-18-/-), or both IL-12p40 and IL-18 (IL-12p40-/-IL-18-/-). Compared with wild-type C57BL/6 mice, IL-12p40-/- mice failed to make a nephritogenic Th1 response and developed markedly reduced crescent formation and renal leukocytic infiltration, despite renal production of chemoattractants and adhesion molecules. IL-18-/- mice developed an intact antigen-specific systemic Th1 response, a similar degree of crescent formation, but fewer glomeruli affected by other severe histologic changes and fewer leukocytes in glomeruli and interstitium. IL-18 was expressed within diseased kidneys. Local production of TNF, IL-1beta, IFN-gamma, CCL3 (MIP-1alpha), and CCL4 (MIP-1beta) was reduced in IL-18-/- mice, demonstrating a local proinflammatory role for IL-18. Combined deletion of IL-12p40 and IL-18 did not result in synergistic effects. Consistent with the hypothesis that inflammation leads to fibrosis, all three groups of deficient mice expressed lower levels of intrarenal TGF-beta1 and/or alpha1(I) procollagen mRNA. These studies demonstrate that in severe experimental crescentic GN, IL-12p40 is the key Th1-defining cytokine chain, whereas IL-18 has local proinflammatory roles.
Pyodermatitis–pyostomatitis vegetans
Authors: M. MEHRAVARAN, L. KEMÉNY, S. HUSZ, I. KOROM, M. KISS, A. DOBOZY
Journal: British Journal of Dermatology (1997)

Journal Article Pyodermatitis–pyostomatitis vegetans Get access M. MEHRAVARAN, M. MEHRAVARAN Department of Dermatology, Albert Szent‐Györgyi Medical University, H‐6701 Szeged, Korányi fasor 6, PO Box 480, Hungary Search for other works by this author on: Oxford Academic Google Scholar L. KEMÉNY, L. KEMÉNY Department of Dermatology, Albert Szent‐Györgyi Medical University, H‐6701 Szeged, Korányi fasor 6, PO Box 480, Hungary Search for other works by this author on: Oxford Academic Google Scholar S. HUSZ, S. HUSZ Department of Dermatology, Albert Szent‐Györgyi Medical University, H‐6701 Szeged, Korányi fasor 6, PO Box 480, Hungary Search for other works by this author on: Oxford Academic Google Scholar I. KOROM, I. KOROM Department of Dermatology, Albert Szent‐Györgyi Medical University, H‐6701 Szeged, Korányi fasor 6, PO Box 480, Hungary Search for other works by this author on: Oxford Academic Google Scholar M. KISS, M. KISS Department of Dermatology, Albert Szent‐Györgyi Medical University, H‐6701 Szeged, Korányi fasor 6, PO Box 480, Hungary Search for other works by this author on: Oxford Academic Google Scholar A. DOBOZY A. DOBOZY Department of Dermatology, Albert Szent‐Györgyi Medical University, H‐6701 Szeged, Korányi fasor 6, PO Box 480, Hungary Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 137, Issue 2, 1 August 1997, Pages 266–269, https://doi.org/10.1046/j.1365-2133.1997.18181914.x Published: 01 August 1997
Nonsteroidal Antiinflammatory Drugs and the Risk of Myocardial Infarction in the General Population
Authors: Luis A. García Rodríguez, Cristina Varas-Lorenzo, Andrew Maguire, Antonio González-Pérez
Journal: Circulation (2004)

Nonsteroidal antiinflammatory drugs (NSAIDs) are reversible inhibitors of cyclooxygenase (COX)-1 and COX-2. Whether transient and incomplete COX-1 inhibition with NSAIDs other than aspirin will translate into clinical cardioprotection is unclear. Some reports suggest that concurrent aspirin and ibuprofen might be associated with lower cardioprotection than aspirin alone because of a pharmacodynamic interaction.We conducted a cohort study with a nested case-control analysis. Overall, 4975 cases of acute myocardial infarction (MI) and death from coronary heart disease (CHD) were identified (January 1997 to December 2000) in the UK. A total of 20,000 controls were randomly sampled, and frequency was matched to cases by age, sex, and calendar year. The incidence rate was 5.0 per 1000 person-years. The multivariate-adjusted OR for current NSAID use compared with nonuse was 1.07 (95% CI, 0.95 to 1.20). Treatment duration or daily dose did not change the results. The effect was similar among patients free of CHD history (1.04; 95% CI, 0.90 to 1.20) and patients with previous history (1.12; 95% CI, 0.91 to 1.38). Estimates for individual NSAIDs were all comparable, with no major effect on the risk of acute MI. Naproxen was associated with an OR of 0.89 (95% CI, 0.64 to 1.24). The OR of aspirin and concurrent NSAIDs use was 1.10 (95% CI, 0.89 to 1.37) compared with aspirin alone. We observed the same result when analyzing ibuprofen and aspirin taken concomitantly.This study could not demonstrate any detectable risk reduction of NSAIDs on the occurrence of MI. Our results do not support the existence of a clinically meaningful interaction between aspirin and NSAIDs, including ibuprofen.
Prostaglandin-stimulated bone resorption by rheumatoid synovia. A possible mechanism for bone destruction in rheumatoid arthritis.
Authors: D R Robinson, A H Tashjian, L Levine
Journal: Journal of Clinical Investigation (1975)

Synovial tissue from patients with rheumatoid arthritis was maintained in organ culture for 3-14 days. Conditioned media from these synovial cultures contained bone resorption-stimulating activity, measured in vitro by using calcium release from mouse calvaria as the assay system. The synovial cultures also produce prostaglandin E2 (PGE2) as measured by serologic methods. The production of both the bone resorption-stimulating activity and PGE2 was inhibited by more than 90% by treatment of the synovial cultures with indomethacin (5 mug/ml). In contrast, treatment of the synovial cultures with colchicine (0.1 mug/ml) caused a marked and parallel increase in the concentration of both bone resorption-stimulating activity and PGE2 in the conditioned media. The bone resorption-stimulating activity was quantitatively extracted into diethyl ether. Within the limits of experimental error, all of the bone resorption-stimulating activity in medium was accounted for by its content of PGE2, itself a potent osteolytic factor. We conclude that the bone resorption-stimulating activity produced by rheumatoid synovia in culture is PGE2.
Using Computer-Based Decision Support to Close the “Know–Do” Gap in Lipid-Lowering Therapy
Authors: Jerry Avorn, Niteesh K. Choudhry
Journal: Circulation (2008)

A strange paradox haunts our attempts to prevent ischemic heart disease.Medicine has addressed the relation between serum lipids and atherosclerosis through a series of scientific triumphs.First, epidemiology demonstrated the association between abnormal cholesterol levels and coronary artery disease.Then, physiology and biochemistry elucidated the pivotal role of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase in the synthesis of lipoproteins.Next, pharmacology led to the development of new medications to target that enzyme without the often-unbearable side effects of earlier drugs.And finally, clinical researchers enrolled tens of thousands of patients at hundreds of centers worldwide to prove the efficacy of these treatments and help guide their use.Taken together, these steps represent one of the finest examples of the application of science to understand and ameliorate human disease.
Highly variable gastric emptying in patients with insulin dependent diabetes mellitus.
Authors: T V Nowak, C P Johnson, J H Kalbfleisch, A M Roza, C M Wood, J P Weisbruch, K H Soergel
Journal: Gut (1995)

Some diabetic patients--particularly those with nausea and vomiting--frequently have evidence of delayed gastric emptying while other diabetic patients may in fact exhibit accelerated gastric emptying. Whether the presence or absence of symptoms of upper gastrointestinal dysfunction correlated with objective measures of gastric emptying in insulin dependent diabetic subjects was investigated. Twenty one insulin dependent diabetic patients underwent a solid phase gastric emptying scintiscan using in vivo labelled chicken liver. Thirteen patients had symptoms suggestive of gastrointestinal dysfunction (nausea, vomiting, early satiety, or constipation), while eight patients had no gastrointestinal symptoms. Eleven patients had orthostatic hypotension. All patients had been diabetic since childhood or adolescence. As a group, the diabetic patients showed a half time (T50) of gastric emptying (mean (SD) 150.0 min (163.7) that was not significantly different from that of 12 healthy control subjects (148.1 min (62.4)). Those diabetic patients without gastrointestinal symptoms and without orthostatic hypotension, however, showed a gastric emptying half time (70.1 min (41.6)) that was significantly faster than that of the control subjects. Conversely, those diabetic patients with nausea, vomiting, and early satiety (or early satiety alone) showed T50 values that were significantly greater than those of the diabetic patients without these symptoms. No correlation was found between the T50 value and the duration of diabetes, the fasting blood glucose at the time of study, or the respiratory variation in heart rate (E:I ratio). These observations indicate that highly variable rates of gastric emptying occur in insulin dependent diabetic patients, and that accelerated gastric emptying may occur in diabetic patients who have no symptoms of gastrointestinal dysfunction.
Yersinia enterocolitica (Pasteurella x) in human enteric infections.
Authors: S. Winblad, B. NilA(C)hn, N. H. Sternby
Journal: BMJ (1966)

BRTMISH 1363were not comparable, having widely differing renal histology.The use of steroids in this situation must remain an open question. SummarySeven patients with fatal acute glomerulonephritis referred to a haemodialysis unit in a three-year period were between 53 and 78 years of age.The presenting features and natural history of acute glomerulonephritis in this age group often differ from those commonly seen in younger patients.The rarity of the disease in the middle-aged and elderly, coupled with the atypical presentation of most of the patients, made the clinical diagnosis difficult.The histological changes included necrosis of glomerular tufts, obliteration of Bowman's space by proliferation of the capsular epithelium, and endothelial proliferation with glomerular exudate.Renal biopsy is valuable in both establish- ing the diagnosis and assessing the severity of the disease, and so avoiding submission of patients with no hope of recovery to unnecessary treatment.
Decreased Incidence of Supravalvar Pulmonary Stenosis After Arterial Switch Operation
Authors: Michael F. Swartz, Ariel Sena, Nader Atallah-Yunes, Cecilia Meagher, Jill M. Cholette, Francisco Gensini, George M. Alfieris
Journal: Circulation (2012)

Supravalvar pulmonary stenosis (SVPS) is frequently observed after arterial switch. Traditionally the coronary arteries are removed from the neopulmonic root by excising the entire sinus of Valsalva. As a result, reconstruction of the neopulmonic root requires a pericardial patch encompassing two-thirds of the anastomosis between the neopulmonic root and pulmonary artery. We present a technique where the coronary arteries are removed as limited buttons of sinus tissue, leaving the transected edge of the neopulmonic root intact. We hypothesize that maintaining native arterial tissue in the anastomosis between the neopulmonic root and the pulmonary artery bifurcation reduces postoperative SVPS.We performed a retrospective review of neonates with D-transposition of the great arteries undergoing arterial switch procedure from 1996 to 2009. Charts were reviewed, and clinical outcomes recorded for each patient. Most recent echocardiograms were evaluated for right ventricular outflow tract obstruction. A total of 120 patients received arterial switch using this technique. There was 99% survival and no injuries to the coronary arteries regardless of anatomy. Total follow-up was 564 patient-years. Mean follow-up at last clinical visit was 66 ± 46 months. Evaluation of the most recent outpatient echocardiogram revealed an average peak instantaneous gradient across the neopulmonic root of 22.5 ± 5 mm Hg. Only 7 (5%) patients required reintervention (balloon dilation, n=5; surgery, n=2).Our technique of removing the coronary arteries as limited buttons, and anastomosis of the pulmonary artery using only native arterial tissue provides excellent midterm results with minimal SVPS.