tbuckley/cabot-search huggingface dataset:
Randomized Controlled Trial of Intensive Versus Conservative Glucose Control in Patients Undergoing Coronary Artery Bypass Graft Surgery: GLUCO-CABG Trial
Authors: Guillermo Umpierrez, Saumeth Cardona, Francisco Pasquel, Sol Jacobs, Limin Peng, Michael Unigwe, Christopher A. Newton, Dawn Smiley-Byrd, Priyathama Vellanki, Michael Halkos, John D. Puskas, Robert A. Guyton, Vinod H. Thourani
Journal: Diabetes Care (2015)

The optimal level of glycemic control needed to improve outcomes in cardiac surgery patients remains controversial.We randomized patients with diabetes (n = 152) and without diabetes (n = 150) with hyperglycemia to an intensive glucose target of 100-140 mg/dL (n = 151) or to a conservative target of 141-180 mg/dL (n = 151) after coronary artery bypass surgery (CABG) surgery. After the intensive care unit (ICU), patients received a single treatment regimen in the hospital and 90 days postdischarge. Primary outcome was differences in a composite of complications, including mortality, wound infection, pneumonia, bacteremia, respiratory failure, acute kidney injury, and major cardiovascular events.Mean glucose in the ICU was 132 ± 14 mg/dL (interquartile range [IQR] 124-139) in the intensive and 154 ± 17 mg/dL (IQR 142-164) in the conservative group (P < 0.001). There were no significant differences in the composite of complications between intensive and conservative groups (42 vs. 52%, P = 0.08). We observed heterogeneity in treatment effect according to diabetes status, with no differences in complications among patients with diabetes treated with intensive or conservative regimens (49 vs. 48%, P = 0.87), but a significant lower rate of complications in patients without diabetes treated with intensive compared with conservative treatment regimen (34 vs. 55%, P = 0.008).Intensive insulin therapy to target glucose of 100 and 140 mg/dL in the ICU did not significantly reduce perioperative complications compared with target glucose of 141 and 180 mg/dL after CABG surgery. Subgroup analysis showed a lower number of complications in patients without diabetes, but not in patients with diabetes treated with the intensive regimen. Large prospective randomized studies are needed to confirm these findings.
Environmental risk factors for the development of psoriatic arthritis: results from a case-control study
Authors: E Pattison, B J Harrison, C E M Griffiths, A J Silman, I N Bruce
Journal: Annals of the Rheumatic Diseases (2007)

<h3>Objective:</h3> To identify potential risk factors for the onset of inflammatory arthritis (IA) in a large cohort of patients with psoriatic arthritis (PsA) of recent onset. <h3>Methods:</h3> We recruited cases with psoriasis and an onset of IA within the past 5 years. Controls were patients who had psoriasis but no arthritis. We assessed potential factors associated with the development of IA using a detailed postal questionnaire. An unmatched analysis adjusted for age and gender was performed. Exposure was censored in the controls at a "dummy-date" assigned randomly in proportion to the percentage of cases developing IA in any given year. <h3>Results:</h3> We studied 98 cases and 163 controls. Exposures showing a positive association before the onset of IA in patients with psoriasis were: rubella vaccination (OR (95% CI) = 12.4 (1.2 to 122)), injury sufficient to require a medical consultation (2.53 (1.1 to 6.0)), recurrent oral ulcers (4.2 (2.0 to 9.0)) and moving house (2.3 (1.2 to 4.4)). Cases were also more likely to have experienced a fractured bone requiring hospital admission (50% vs 9%, p = 0.040). <h3>Conclusions:</h3> We found a number of environmental exposures associated with the onset of IA in subjects with psoriasis. The strongest associations were with trauma thereby adding to the hypothesis of a "deep Koebner phenomenon" in PsA. Our data also suggest that exposure of the immune system to certain infection-related triggers may also be of relevance. Further studies are needed to verify these observations and to examine potential immunological mechanisms that underlie them.
Physician Payment Policies: Impacts and Implications
Authors: Thomas Rice
Journal: Annual Review of Public Health (1997)

▪ Abstract This paper reviews recent changes in physician payment policies, examines evidence on their impacts, and discusses their implications for researchers and policy makers. It first develops a conceptual framework to help explore the economic incentives inherent in different physician payment schemes. It then reviews evidence on the impacts of recent changes in physician payment methods; first, for fee-for-service, and then for capitated systems like HMOs. It concludes that much more research needs to be conducted on HMOs to determine the impact of different physician payment incentives on utilization, expenditures, clinical outcomes, and patient satisfaction.
The immediate effect of the Same-Sex Marriage Prohibition Act on stigma, discrimination, and engagement on HIV prevention and treatment services in men who have sex with men in Nigeria: analysis of prospective data from the TRUST cohort
Authors: Sheree R Schwartz, Rebecca G Nowak, Ifeanyi Orazulike, Babajide Keshinro, Julie Ake, Sara Kennedy, Ogbonnaya Njoku, William A Blattner, Manhattan E Charurat, Stefan D Baral
Journal: The Lancet HIV (2015)
Deletion of the Endothelial Bmx Tyrosine Kinase Decreases Tumor Angiogenesis and Growth
Authors: Tanja Holopainen, Vanessa López- Alpuche, Wei Zheng, Ritva Heljasvaara, Dennis Jones, Yun He, Denis Tvorogov, Gabriela D'Amico, Zoltan Wiener, Leif C. Andersson, Taina Pihlajaniemi, Wang Min, Kari Alitalo
Journal: Cancer Research (2012)

Bmx, [corrected] also known as Etk, is a member of the Tec family of nonreceptor tyrosine kinases. Bmx is expressed mainly in arterial endothelia and in myeloid hematopoietic cells. Bmx regulates ischemia-mediated arteriogenesis and lymphangiogenesis, but its role in tumor angiogenesis is not known. In this study, we characterized the function of Bmx in tumor growth using both Bmx knockout and transgenic mice. Isogenic colon, lung, and melanoma tumor xenotransplants showed reductions in growth and tumor angiogenesis in Bmx gene-deleted ((-/-)) mice, whereas developmental angiogenesis was not affected. In addition, growth of transgenic pancreatic islet carcinomas and intestinal adenomas was also slower in Bmx(-/-) mice. Knockout mice showed high levels of Bmx expression in endothelial cells of tumor-associated and peritumoral arteries. Moreover, endothelial cells lacking Bmx showed impaired phosphorylation of extracellular signal-regulated kinase (Erk) upon VEGF stimulation, indicating that Bmx contributes to the transduction of vascular endothelial growth factor signals. In transgenic mice overexpressing Bmx in epidermal keratinocytes, tumors induced by a two-stage chemical skin carcinogenesis treatment showed increased growth and angiogenesis. Our findings therefore indicate that Bmx activity contributes to tumor angiogenesis and growth.
Severity of COPD and six-minute walk test
Authors: Ricardo Coelho, Raquel Rosa, Ana Sofia Santos, Sofia Granadeiro, Alexandra Borba, Luísa Semedo, João Cardoso
Journal: European Respiratory Journal (2013)

Background: Patients with chronic obstructive pulmonary disease (COPD) develop progressive disability and impairment in quality of life. The six-minute walk test (6MWT) is widely used do assess changes in functional exercise capacity in these patients.  Aim: To evaluate the 6MWT results in COPD patients classified by severity of airflow limitation.  Methods: 43 consecutive COPD patients were submitted to a spirometric evaluation and a 6MWT according to international recommendations. The distance walked, the percentage of predicted distance (Troosters’ equation), the oxygen desaturation index (ODI), the Borg dyspnoea index post-test (BDI) and maximal heart rate (M-HR) were recorded. Patients were stratified according to GOLD guidelines. ANOVA test was applied to define the differences between groups; statistical significance was admitted for values of p   Results: 12 patients were GOLD 2, 17 patients were GOLD 3 and 14 patients were GOLD 4. The results are shown below:  There is significant statistical difference in ODI between GOLD 2 and GOLD 4 patients (p=0,03). For all the other variables there was no statistical difference between GOLD groups (p>0,05).  Conclusion: Despite the small population analyzed, these results suggest that the 6MWT and spirometry are more likely to be complementary methods for the evaluation of the impairment in functional status of COPD patients. Nevertheless our results show that GOLD 2 patients have significant compromise of functional capacity, quite similar to more severe patients.
Anemia, Blood Loss, and Blood Transfusions in North American Children in the Intensive Care Unit
Authors: Scot T. Bateman, Jacques Lacroix, Katia Boven, Peter Forbes, Roger Barton, Neal J. Thomas, Brian Jacobs, Barry Markovitz, Brahm Goldstein, James H. Hanson, H. Agnes Li, Adrienne G. Randolph
Journal: American Journal of Respiratory and Critical Care Medicine (2008)

Rationale: Minimizing exposure of children to blood products is desirable.Objectives: We aimed to understand anemia development, blood loss, and red blood cell (RBC) transfusions in the pediatric intensive care unit (PICU).Methods: Prospective, multicenter, 6-month observational study in 30 PICUs. Data were collected on consecutive children (<18 yr old) in the PICU for 48 hours or more.Measurements and Main Results: Anemia development, blood loss, and RBC transfusions were measured. A total of 977 children were enrolled. Most (74%) children were anemic in the PICU (33% on admission, 41% developed anemia). Blood draws accounted for 73% of daily blood loss; median loss was 5.0 ml/day. Forty-nine percent of children received transfusions; 74% of first transfusions were on Days 1–2. After adjusting for age and illness severity, compared with nontransfused children, children who underwent transfusion had significantly longer days of mechanical ventilation (2.1 d, P < 0.001) and PICU stay (1.8 d, P = 0.03), and had increased mortality (odds ratio [OR], 11.6; 95% confidence interval [CI], 1.43–90.9; P = 0.02), nosocomial infections (OR, 1.9; 95% CI, 1.2–3.0; P = 0.004), and cardiorespiratory dysfunction (OR, 2.1; 95% CI, 1.5–3.0; P < 0.001). High blood loss per kilogram body weight from blood draws (OR, 1.11; 95% CI, 1.03–1.2; P = 0.01) was associated with RBC transfusion more than 48 hours after admission. The most common indication for transfusion was low hemoglobin (42%). Pretransfusion hemoglobin values varied greatly (mean, 9.7 ± 2.7 g/dl).Conclusions: Critically ill children are at significant risk for developing anemia and receiving blood transfusions. Transfusion in the PICU was associated with worse outcomes. It is imperative to minimize blood loss from blood draws and to set clear transfusion thresholds.
Corneal Confocal Microscopy Identifies Small-Fiber Neuropathy in Subjects With Impaired Glucose Tolerance Who Develop Type 2 Diabetes
Authors: Shazli Azmi, Maryam Ferdousi, Ioannis N. Petropoulos, Georgios Ponirakis, Uazman Alam, Hassan Fadavi, Omar Asghar, Andrew Marshall, Andrew J. Atkinson, Wendy Jones, Andrew J.M. Boulton, Mitra Tavakoli, Maria Jeziorska, Rayaz A. Malik
Journal: Diabetes Care (2015)

OBJECTIVE Impaired glucose tolerance (IGT) through to type 2 diabetes is thought to confer a continuum of risk for neuropathy. Identification of subjects at high risk of developing type 2 diabetes and, hence, worsening neuropathy would allow identification and risk stratification for more aggressive management. RESEARCH DESIGN AND METHODS Thirty subjects with IGT and 17 age-matched control subjects underwent an oral glucose tolerance test, assessment of neuropathic symptoms and deficits, quantitative sensory testing, neurophysiology, skin biopsy, and corneal confocal microscopy (CCM) to quantify corneal nerve fiber density (CNFD), branch density (CNBD), and fiber length (CNFL) at baseline and annually for 3 years. RESULTS Ten subjects who developed type 2 diabetes had a significantly lower CNFD (P = 0.003), CNBD (P = 0.04), and CNFL (P = 0.04) compared with control subjects at baseline and a further reduction in CNFL (P = 0.006), intraepidermal nerve fiber density (IENFD) (P = 0.02), and mean dendritic length (MDL) (P = 0.02) over 3 years. Fifteen subjects who remained IGT and 5 subjects who returned to normal glucose tolerance had no significant baseline abnormality on CCM or IENFD but had a lower MDL (P &amp;lt; 0.0001) compared with control subjects. The IGT subjects showed a significant decrease in IENFD (P = 0.02) but no change in MDL or CCM over 3 years. Those who returned to NGT showed an increase in CNFD (P = 0.05), CNBD (P = 0.04), and CNFL (P = 0.05), but a decrease in IENFD (P = 0.02), over 3 years. CONCLUSIONS CCM and skin biopsy detect a small-fiber neuropathy in subjects with IGT who develop type 2 diabetes and also show a dynamic worsening or improvement in corneal and intraepidermal nerve morphology in relation to change in glucose tolerance status.
Myocardial repair/remodelling following infarction: roles of local factors
Authors: Y. Sun
Journal: Cardiovascular Research (2008)

Heart failure is a global health problem, appearing most commonly in patients with previous myocardial infarction (MI). Cardiac remodelling, particularly fibrosis, seen in both the infarcted and non-infarcted myocardium is recognized to be a major determinant of the development of impaired ventricular function, leading to a poor prognosis. Elucidating cellular and molecular mechanisms responsible for the accumulation of extracellular matrix is essential for designing cardioprotective and reparative strategies that could regress fibrosis after infarction. Multiple factors contribute to left ventricular remodelling at different stages post-MI. This review will discuss the role of oxidative stress and locally produced angiotensin II in the pathogenesis of myocardial repair/remodelling after MI.
Time to angiographic reperfusion and clinical outcome after acute ischaemic stroke: an analysis of data from the Interventional Management of Stroke (IMS III) phase 3 trial
Authors: Pooja Khatri, Sharon D Yeatts, Mikael Mazighi, Joseph P Broderick, David S Liebeskind, Andrew M Demchuk, Pierre Amarenco, Janice Carrozzella, Judith Spilker, Lydia D Foster, Mayank Goyal, Michael D Hill, Yuko Y Palesch, Edward C Jauch, E Clarke Haley, Achala Vagal, Thomas A Tomsick
Journal: The Lancet Neurology (2014)
Prophylactic neutrophil elastase inhibitor (sivelestat) attenuates subsequent ventilator-induced lung injury
Authors: Dohyung Kim, Jaeho Jung
Journal: European Respiratory Journal (2014)

Background

Sivelestat has the maximized curative effect in early acute lung injury (ALI) by inhibiting neutrophil elastase. The ventilator induced lung injury (VILI) is also related with neutrophil. We thought the early use of Silvelestat has preventive effect of VILI.

Aims

We tested the preventive effect of sivelestat on VILI in a rat model.

Method

Rat received mechanical ventilation with a high tidal volume (VT; 20 ml/kg) for 3 h. Rat as categorized as (1) Sham group (2) VILI group, (3) Sivelestat pretreated group: sivelestat (100 mg/kg ) 30 min before ventilation (4) Sivelestat treated group: sivelestat (100 mg/kg ) at the time of ventilation start. The degree of lung injury was assessed by measurements of lung wet-weight to dry-weight ratio, bronchoalveoalar lavage fluid protein and neutrophil count.

Results

The ratio of wet-to-dry weight was significantly decreased in both Silvelestat groups (before 30 min group: 6.81±0.41, the time ventilator start group(7.90±1.98) compared with control group (8.95±1.03), and, the ratio of wet-to-dry weight was significantly attenuated in the pretreated group comparing ventilator start group(P<0.05). The neturophil counts and protein concentration of bronchoalveolar lavage fluid (BALF) were also significantly lower in both Silvelestat using groups compared with control group(P<0.05). Especially. the pretreated Sivelestat group significantly reduced the protein concentration and neutrophil count compared with ventilator start using group(P<0.05). .

Conclusions: The early using of Sivelestat attenuate the VILI in rat model, the Silvelestat preventive using is more effective than using after lung injury.
Myeloid cells, BAFF, and IFN-γ establish an inflammatory loop that exacerbates autoimmunity in Lyn-deficient mice
Authors: Patrizia Scapini, Yongmei Hu, Ching-Liang Chu, Thi-Sau Migone, Anthony L. DeFranco, Marco A. Cassatella, Clifford A. Lowell
Journal: The Journal of Experimental Medicine (2010)

Autoimmunity is traditionally attributed to altered lymphoid cell selection and/or tolerance, whereas the contribution of innate immune cells is less well understood. Autoimmunity is also associated with increased levels of B cell–activating factor of the TNF family (BAFF; also known as B lymphocyte stimulator), a cytokine that promotes survival of self-reactive B cell clones. We describe an important role for myeloid cells in autoimmune disease progression. Using Lyn-deficient mice, we show that overproduction of BAFF by hyperactive myeloid cells contributes to inflammation and autoimmunity in part by acting directly on T cells to induce the release of IFN-γ. Genetic deletion of IFN-γ or reduction of BAFF activity, achieved by either reducing myeloid cell hyperproduction or by treating with an anti-BAFF monoclonal antibody, reduced disease development in lyn−/− mice. The increased production of IFN-γ in lyn−/− mice feeds back on the myeloid cells to further stimulate BAFF release. Expression of BAFF receptor on T cells was required for their full activation and IFN-γ release. Overall, our data suggest that the reciprocal production of BAFF and IFN-γ establishes an inflammatory loop between myeloid cells and T cells that exacerbates autoimmunity in this model. Our findings uncover an important pathological role of BAFF in autoimmune disorders.
Management of relapse and survival in advanced stage Hodgkin’s disease: The EORTC experience
Authors: J. M. V. Burgers, R. Somers, M. Henry-Amar, M. Tarayre, P. Carde, J. Thomas, A. Hagenbeek, M. Monconduit, B. E. de Pauw, W. P. M. Breed, L. Verdonck, M. Hayat, R. Zittoun
Journal: Annals of Oncology (1991)
Dipyridamole decreases glomerular filtration in the sodium-depleted dog. Evidence for mediation by intrarenal adenosine.
Authors: L J Arend, C I Thompson, W S Spielman
Journal: Circulation Research (1985)

To determine the renal effects of inhibiting the uptake and subsequent metabolism of endogenous adenosine, dipyridamole, a nucleoside transport inhibitor, was infused intrarenally into anesthetized dogs. Dipyridamole (24 micrograms/kg per min) inhibited the cellular extraction of [14C]adenosine (72 +/- 3% vs. 9 +/- 3%) and elevated the excretion of endogenous adenosine (0.60 +/- 0.08 to 1.70 +/- 0.21 nmol/min, P less than 0.05). The action of exogenous adenosine to decrease glomerular filtration rate is known to be enhanced by sodium depletion, and is minimal or absent in sodium-loaded animals. To ascertain whether dietary sodium intake alters the renal effects of elevated endogenous adenosine, dipyridamole was infused into sodium-depleted and sodium-loaded dogs. In the sodium-depleted dogs (n = 9), dipyridamole infusion decreased the glomerular filtration rate by 59 +/- 7% (20 +/- 1 to 8 +/- 2 ml/min, P less than 0.05) which returned to control levels within 30 minutes after stopping infusion of dipyridamole. Renal vascular resistance was unchanged during dipyridamole infusion. In the sodium-loaded dogs (n = 5), dipyridamole had no effect on glomerular filtration rate (22 +/- 4 vs. 25 +/- 3 ml/min) or renal vascular resistance. In a separate series of sodium-depleted dogs (n = 8), the dipyridamole-induced decrease in glomerular filtration rate was completely reversed or inhibited by theophylline, an adenosine receptor antagonist. These experiments demonstrate that inhibition of cellular uptake of adenosine elevates adenosine levels, that dipyridamole decreases glomerular filtration rate in sodium-depleted but not sodium-loaded dogs, and that the decrease in glomerular filtration rate is inhibited by theophylline. We conclude that the decrease in glomerular filtration rate during dipyridamole administration is mediated by increased endogenous adenosine.
Nonmyeloablative conditioning followed by transplantation of genetically modified HLA-matched peripheral blood progenitor cells for hematologic malignancies in patients with acquired immunodeficiency syndrome
Authors: Elizabeth M. Kang, Moniek de Witte, Harry Malech, Richard A. Morgan, Sheila Phang, Charles Carter, Susan F. Leitman, Richard Childs, A. John Barrett, Richard Little, John F. Tisdale
Journal: Blood (2002)
A Double-Blind, Placebo-Controlled Trial Combining Sertraline and Naltrexone for Treating Co-Occurring Depression and Alcohol Dependence
Authors: Helen M. Pettinati, David W. Oslin, Kyle M. Kampman, William D. Dundon, Hu Xie, Thea L. Gallis, Charles A. Dackis, Charles P. O'Brien
Journal: American Journal of Psychiatry (2010)

Empirical evidence has only weakly supported antidepressant treatment for patients with co-occurring depression and alcohol dependence. While some studies have demonstrated that antidepressants reduce depressive symptoms in individuals with depression and alcohol dependence, most studies have not found antidepressant treatment helpful in reducing excessive drinking in these patients. The authors provide results from a double-blind, placebo-controlled trial that evaluated the efficacy of combining approved medications for depression (sertraline) and alcohol dependence (naltrexone) in treating patients with both disorders.A total of 170 depressed alcohol-dependent patients were randomly assigned to receive 14 weeks of treatment with sertraline (200 mg/day [N=40]), naltrexone (100 mg/day [N=49]), the combination of sertraline plus naltrexone (N=42), or double placebo (N=39) while receiving weekly cognitive-behavioral therapy.The sertraline plus naltrexone combination produced a higher alcohol abstinence rate (53.7%) and demonstrated a longer delay before relapse to heavy drinking (median delay=98 days) than the naltrexone (abstinence rate: 21.3%; delay=29 days), sertraline (abstinence rate: 27.5%; delay=23 days), and placebo (abstinence rate: 23.1%; delay=26 days) groups. The number of patients in the medication combination group not depressed by the end of treatment (83.3%) approached significance when compared with patients in the other treatment groups. The serious adverse event rate was 25.9%, with fewer reported with the medication combination (11.9%) than the other treatments.More depressed alcohol-dependent patients receiving the sertraline plus naltrexone combination achieved abstinence from alcohol, had delayed relapse to heavy drinking, reported fewer serious adverse events, and tended to not be depressed by the end of treatment.
Antibodies to idiotypes of isologous immunoglobulins.
Authors: N Sakato, H N Eisen
Journal: The Journal of Experimental Medicine (1975)

To determine if the immunoglobulins (Igs) capable of eliciting the formation of isologous anti-idiotypic antibodies are rare exceptions, BABL/c mice were immunized with five myeloma proteins of BALB/c origin. Anti-idiotypes were produced against all but one. The idiotype of the exception (T15) is remarkably abundant in BALB/c mice, whose unresponsiveness is probably due to tolerance. Nevertheless, prolonged immunization with T15 finally induced the formation of isologous antibodies that seemed largely to be specific for IgA proteins, especially those with k-light-chains; the reactions of a few of these isologous antisera with T15 were slightly inhibited by phosphorylcholine, suggesting that some anti-idiotypes were probably formed even to this unusually prevalent idiotype. It is likelythat under appropriate conditions almost any myeloma protein can elicit isologous anti-idiotypes.