tbuckley/cabot-search huggingface dataset:
Risk of HIV-1 acquisition among women who use different types of injectable progestin contraception in South Africa: a prospective cohort study
Authors: Lisa M Noguchi, Barbra A Richardson, Jared M Baeten, Sharon L Hillier, Jennifer E Balkus, Z Mike Chirenje, Katherine Bunge, Gita Ramjee, Gonasagrie Nair, Thesla Palanee-Phillips, Pearl Selepe, Ariane van der Straten, Urvi M Parikh, Kailazarid Gomez, Jeanna M Piper, D Heather Watts, Jeanne M Marrazzo
Journal: The Lancet HIV (2015)
Serious infections in patients with ankylosing spondylitis with and without TNF blockers: a systematic review and meta-analysis of randomised placebo-controlled trials
Authors: A. Fouque-Aubert, L. Jette-Paulin, C. Combescure, A. Basch, J. Tebib, L. Gossec
Journal: Annals of the Rheumatic Diseases (2009)

<h3>Background</h3> Tumour necrosis factor (TNF) blockers are known to increase the risk of serious infections in rheumatoid arthritis. Despite wide use of TNF blockers in ankylosing spondylitis (AS), the infection risk has never been evaluated in this disease. <h3>Objectives</h3> To assess serious infections in patients with AS not exposed and exposed to TNF blockers. <h3>Methods</h3> A systematic literature review up to May 2008 using PubMed, EMBASE and Cochrane Library was performed. All randomised controlled trials (RCTs) published between 1995 and 2008 monitoring serious infections, treated with non-steroidal anti-inflammatory drugs (NSAIDs) or TNF blockers, were included. Infection risks were calculated by naive pooling and for 100 patient-years (pyrs) of exposure. To assess the serious infection risk with TNF blockers, a meta-analysis of RCTs was performed using Mantel–Haenszel9s method with several sensitivity analyses. <h3>Results</h3> Fourteen RCTs were included (3345 patients). With placebo or NSAIDs (N=2202), two serious infections were observed (0.09%, range 0.01% to 0.3%)—that is, 0.4/100 pyrs. In TNF blocker trials, two serious infections were observed with placebo (2/500, 0.4% (0.0% to 1.4%), ie, 1.0/100 pyrs) versus 14 serious infections with TNF blockers (14/996, 0.7% (0.3% to 1.4%), ie, 1.9/100 pyrs). Meta-analysis of the RCTs showed that the increase in serious infections with TNF blockers compared with placebo was not significant: risk difference=0.4% (−8% to 1.6%). <h3>Conclusions</h3> The absolute risk of serious infections in patients with AS not exposed to TNF blockers is low. The absolute risk of serious infections in patients receiving TNF blockers is higher, but the difference was found to be not significant, possibly through lack of power. Continued monitoring is necessary.
Inhibitors of Microsomal Prostaglandin E<sub>2</sub> Synthase‐1 Enzyme as Emerging Anti‐Inflammatory Candidates
Authors: Malkeet Singh Bahia, Yogesh Kumar Katare, Om Silakari, Bhawna Vyas, Pragati Silakari
Journal: Medicinal Research Reviews (2014)

Abstract Cyclooxygenases (COX‐1 and COX‐2) catalyze the conversion of arachidonic acid (AA) into PGH 2 that is further metabolized by terminal prostaglandin (PG) synthases into biologically active PGs, for example, prostaglandin E 2 (PGE 2 ), prostacyclin I 2 (PGI 2 ), thromboxane A 2 (TXA 2 ), prostaglandin D 2 (PGD 2 ), and prostaglandin F 2 alpha (PGF 2α ). Among them, PGE 2 is a widely distributed PG in the human body, and an important mediator of inflammatory processes. The successful modulation of this PG provides a beneficial strategy for the potential anti‐inflammatory therapy. For instance, nonsteroidal anti‐inflammatory agents (NSAIDs), both classical nonselective ( c NSAIDs) and the selective COX‐2 inhibitors (coxibs) attenuate the generation of PGH 2 from AA that in turn reduces the synthesis of PGE 2 and modifies the inflammatory conditions. However, the long‐term use of these agents causes severe side effects due to the nonselective inhibition of other PGs, such as PGI 2 and TXA 2 , etc. Microsomal prostaglandin E 2 synthase‐1 (mPGES‐1), a downstream PG synthase, specifically catalyzes the biosynthesis of COX‐2‐derived PGE 2 from PGH 2 , and describes itself as a valuable therapeutic target for the treatment of acute and chronic inflammatory disease conditions. Therefore, the small molecule inhibitors of mPGES‐1 would serve as a beneficial anti‐inflammatory therapy, with reduced side effects that are usually associated with the nonselective inhibition of PG biosynthesis.
Conflicts of interest. Profits and problems in physician referrals
Authors: E. H. Morreim
Journal: JAMA (1989)

Increasing numbers of physicians are investing in outpatient facilities to which their own patients may be referred. These investments raise ethical questions about conflicts of interest, leading to consideration of physician income over patient welfare, and to overbilling of payors. There have been calls for legislation prohibiting physicians altogether from investing in health facilities or from referring patients to facilities in which they have a financial interest. Morreim believes that such legal prohibitions could intrude on the physician patient relationship, restrain trade, and deter the development of better, more cost-efficient ways of delivering care. She argues that utilization review, quality assurance, and a judicially fashioned, case-specific common law remedy are better ways to protect the interests of payors and patients.
Characteristics and outcome of patients with second primary lung cancer
Authors: Niels Reinmuth, Andreas Stumpf, Patrick Stumpf, Thomas Muley, Sonja Kobinger, Hans Hoffmann, Felix J.F. Herth, Philipp A. Schnabel, Arne Warth, Helge Bischoff, Michael Thomas
Journal: European Respiratory Journal (2012)

Patients with lung cancer are at risk of developing a second primary lung cancer (SPLC). However, the characteristics of patients at risk remain largely speculative. We reviewed 2816 lung cancer patients from our institution for the occurrence of SPLC. Any SPLC was categorised as synchronous when diagnosed within 2 years of the first primary lung cancer (FPLC) and after direct histological comparison of both tumours. All other SPLCs were considered as metachronous. 139 patients developed a second malignancy including 69 nonsmall cell lung cancer (NSCLC) and 9 small cell lung cancer. The median interval for diagnosis of metachronous SPLC (n=59) after FPLC occurrence was 72 months. SPLC detected within 5 years of FPLC diagnosis had a more favourable stage distribution (p=0.02). After diagnosis of SPLC, patients had a superior median overall survival compared to controls (57.7 versus 18.1 months; p<0.0001). Interestingly, comparing only stage IV NSCLC patients, a history of FPLC was also associated with a favourable survival (median 27.4 versus 8.97 months; p=0.007). In summary, previous lung cancer treatment does not lead to impaired prognosis after diagnosis of SPLC. Improved surveillance programmes beyond 5 years after FPLC treatment may result in more favourable disease stages for detected SPLC.
Treatment of IgA Nephropathy with ACE Inhibitors
Authors: Manuel Praga, Eduardo Gutiérrez, Ester González, Enrique Morales, Eduardo Hernández
Journal: Journal of the American Society of Nephrology (2003)

ABSTRACT. Some retrospective studies have suggested a beneficial influence of angiotensin-converting enzyme (ACE) inhibitors on the progression of IgA nephropathy (IgAN), but prospective and controlled studies demonstrating this effect are lacking. Forty-four patients with biopsy-proven IgAN, proteinuria ≥ 0.5 g/d, and serum creatinine (SCr) ≤ 1.5 mg/dl were randomly assigned either to receive enalapril (<i>n</i> = 23) or to a control group (<i>n</i> = 21) in whom BP was controlled with antihypertensives other than ACE inhibitors. Primary outcome was renal survival estimated by a 50% increase in baseline SCr. Secondary outcomes were the presence of a SCr &gt; 1.5 mg/dl at the last visit and the evolution of proteinuria. Baseline clinical findings were similar at baseline between enalapril-treated and control group, and there were no differences in BP control during follow-up. Mean follow-up was 78 ± 37 mo in the enalapril group and 74 ± 36 mo in the control group. Three patients (13%) in the enalapril group and 12 (57%) in the control group reached the primary end point (<i>P</i> &lt; 0.05). Kaplan-Meier renal survival was significantly better in enalapril group than in control group: 100% <i>versus</i> 70% after 4 yr and 92% <i>versus</i> 55% after 7 yr (<i>P</i> &lt; 0.05). Three patients in the enalapril group (13%) and 11 (52%) in the control group showed SCr &gt; 1.5 mg/dl at the last visit (<i>P</i> &lt; 0.05). Proteinuria significantly decreased in the enalapril group, whereas it tended to increase in the control group (<i>P</i> &lt; 0.001 between groups). In conclusion, ACE inhibitors significantly improve renal survival in proteinuric IgAN with normal or moderately reduced renal function. E-mail: mpragat@senefro.org
Expression pattern of CD45 RA/RO isoformic antigens in T‐lineage neoplasms
Authors: Seiji Kawano, Eiji Tatsumi, Noriko Yoneda, Akemi Tani, Fumihiko Nakamura
Journal: American Journal of Hematology (1995)

Abstract The expression of CD45 RA/RO antigen was investigated in neoplasms including cases expressing CD7 antigen as the sole pan‐T antigen (n = 8), T‐lineage acute lymphoblastic leukemia (ALL)/lymphoblastic lymphoma (LBL) at various stages of differentiation (n = 32), peripheral stage T‐lineage leukemia (n = 10) and adult T‐cell leukemia (ATL) (n = 14). The p56 Ick gene expression was also investigated in selected cases. The expression pattern of CD45 RA/RO antigen was defined as of RA, mixed, or RO type. All but one CD7+ CD5− CD2− case were of the RA type. The CD7+ CD5+ CD2− prothy‐mic stage included seven RA and one mixed type cases. One CD7+ CD5− CD2+ case was of the RA type, but the other was of the RO type. The CD7+ CD5+ CD2+ prothymic stage included three RA and four mixed type cases. All seven CD3− CD4+ CD8+ (double‐positive) thymic cases were of the RO type. The CD3+ CD4+ CD8+ (triple‐positive) stage included two RO and three mixed‐type cases. One CD3+ CD4+ CD8− late thymic case was of the mixed type. The peripheral stage cases included five RA, three RO, and two mixed type cases. All ATL cases were of the RO type. The expression of p56 Ick gene in the prothymic stage was less marked than that in the thymic stage. On the basis of these results, the following sequence of pattern of the CD45 RA/RO antigen expression along with T‐lineage differentiation was reconstructed: prothymic stage [RA and mixed type] → double‐positive thymic stage [RO type] → triple‐positive thymic stage [RO and mixed type] → peripheral stage [RA, mixed, and RO type]. While one RO‐type CD7+ CD5− CD2− and one RO‐type CD7+ CD5− CD2+ cases were not in accord with this sequence, the pattern of CD45 RA/RO antigen expression in most of T‐lineage neoplasms could be determined by the respective stage of differentiation. The poor expression of the p56 Ick gene by the prothymic blasts compared with the thymic blasts may be related to the expression pattern of the CD45 RA/RO molecules, which exhibits phosphatase activity. The consistent RO‐type expression in the ATL cases may reflect the activated status of the neoplastic T cells due to the presence of the HTLV‐I gene. Alternatively, the target cells for HTLV‐I‐induced neoplastic transformation may possibly be of the RO type. © 1995 Willey‐Liss, Inc.
Long-term asthma treatment guided by airway hyperresponsiveness in children: a randomised controlled trial
Authors: M. Nuijsink, W. C. J. Hop, P. J. Sterk, E. J. Duiverman, J. C. de Jongste
Journal: European Respiratory Journal (2007)

Management plans for childhood asthma show limited success in optimising asthma control. The aim of the present study was to assess whether a treatment strategy guided by airway hyperresponsiveness (AHR) increased the number of symptom-free days and improved lung function in asthmatic children, compared with a symptom-driven reference strategy. In a multicentre, double-blind, parallel-group, randomised, 2-yr intervention trial, 210 children (aged 6–16 yrs) with moderate atopic asthma, selected on the basis of symptom scores and/or the presence of AHR, were studied. At 3-monthly visits, symptom scores, forced expiratory volume in one second (FEV 1 ) and methacholine challenge results were obtained, and medication (five levels of fluticasone with or without salmeterol) adjusted according to algorithms based on symptom score (reference strategy, n = 104) or AHR and symptom score (AHR strategy, n = 102). After 2 yrs, no difference was found in the percentage of symptom-free days between treatment strategies. Pre-bronchodilator FEV 1 was higher in the AHR strategy (2.3% predicted). This was entirely explained by a gradual worsening of FEV 1 in a subgroup of 91 hyperresponsive children enrolled with low symptom scores (final difference between study arms was 6%). Asthma treatment guided by airway hyperresponsiveness showed no benefits in terms of number of symptom-free days, but produced a better outcome in terms of pre-bronchodilator forced expiratory volume in one second in allergic asthmatic children, especially those characterised by low symptom scores despite airway hyperresponsiveness.
Why bone–patella tendon–bone grafts should still be considered the gold standard for anterior cruciate ligament reconstruction
Authors: James R Carmichael, Mervyn J Cross
Journal: British Journal of Sports Medicine (2009)

The patient population that will place the highest demand on the structural integrity and function of an ACL graft, whilst at the same time having the lowest tolerance for any donor site morbidity, is the professional sportsman or woman. The graft most appropriate for this group, regardless of technical difficulties, should therefore be considered the gold standard. We believe that the bone – patella tendon – bone (BPTB) graft best fits these criteria.

Proponents of the hamstring-based reconstruction will often cite the morbidity of the patellar tendon harvest, rather than the merits of the hamstrings, as the principal reason for avoiding the use of BPTB. Concerns exist regarding quadriceps deficit, arthritis, postoperative stiffness, anterior knee pain and sensory disturbance. The complications associated with hamstrings grafts must not be forgotten. These include increased knee laxity, hamstrings deficit and pain, tunnel widening, anterior knee pain and sensory deficit.

### Graft laxity and fixation

The stability of the hamstrings reconstruction when compared with the BPTB graft is frequently questioned. It is a common finding that there is a trend to increased laxity when hamstrings grafts are used.1–3 This has been confirmed in a meta-analysis by Goldblatt et al , who identified a marked reduction in side-to-side laxity difference with the use of the BPTB graft.4 A similar analysis by Forster et al identified a trend to increased chance of a positive pivot jerk in the hamstrings group.5 When laxity is identified in a BPTB graft it is usually associated with tunnel misplacement.6

The cause for the increased laxity with hamstrings has been studied. In 2002 Rittmeister et al analysed the components of postoperative laxity in a cadaveric study.7 They found that the majority of graft slippage occurred at the graft bone interface, with only 8% of elongation being due to plastic …
Tumor Necrosis Factor-α Receptor 1 Is a Major Predictor of Mortality and New-Onset Heart Failure in Patients With Acute Myocardial Infarction
Authors: Marco Valgimigli, Claudio Ceconi, Patrizia Malagutti, Elisa Merli, Olga Soukhomovskaia, Gloria Francolini, Giordano Cicchitelli, Adriana Olivares, Giovanni Parrinello, Gianfranco Percoco, Gabriele Guardigli, Donato Mele, Roberto Pirani, Roberto Ferrari
Journal: Circulation (2005)

Tumor necrosis factor alpha-alpha (TNF-alpha) activation is an independent prognostic indicator of mortality in patients with heart failure (HF). Despite the recognition that several TNF family cytokines are elevated during myocardial infarction, their role in predicting subsequent prognosis in these setting remains poorly understood.We performed a systematic evaluation of TNF-alpha and its type 1 and 2 soluble receptors, together with interleukin (IL)-6, IL-1 receptor antagonist, and IL-10, in 184 patients (132 men; mean age, 64+/-12) consecutively admitted for myocardial infarction. We correlated their values to short- and long-term incidence of death and HF (primary outcome). In 10 patients, we also studied the presence of transcardiac gradients for TNF-alpha and its soluble receptors. The control group comprised 45 healthy subjects who were sex and age matched (33 men; mean age, 65+/-6 years) to the patients. All tested cytokines were increased in patients, and no transcardiac or systemic AV difference was found. After a median follow-up of 406 days (range, 346 to 696 days), 24 patients died and 32 developed HF. Univariate analysis showed that all cytokines were related to outcome, whereas after adjustment for baseline and clinical characteristics, sTNFR-1 remained the only independent predictor of death and HF (hazard ratio, 2.9; 95% CI, 1.9 to 3.8, tertile 1 versus 3), together with left ventricular ejection fraction, Killip class, and creatine kinase-MB at peak.sTNFR-1 is a major short- and long-term predictor of mortality and HF in patients with acute myocardial infarction.
Effect of sodium taurocholate on gastric secretion in patients with duodenal ulceration
Authors: M R Lewin, E Pifano, R D Daniel, P B Boulos, C G Clark
Journal: Gut (1983)

The effect of sodium taurocholate instillation on the stimulated stomachs of patients with duodenal ulceration has been investigated. Instillation into the stomach of sodium taurocholate significantly reduced pentagastrin stimulated volume and outputs of both acid and sodium, with no change in the calculated volume of duodenogastric reflux. These observations are not consistent with the back-diffusion theory, but suggest direct parietal cell inhibition of gastric secretion by sodium taurocholate.
How Cost-Effective Is the Treatment of Dyslipidemia in Patients With Diabetes but Without Cardiovascular Disease?
Authors: Steven A. Grover, Louis Coupal, Hanna Zowall, Charles M. Alexander, Thomas W. Weiss, Daniel R.J. Gomes
Journal: Diabetes Care (2001)

OBJECTIVE— Epidemiological studies have shown that the risk of myocardial infarction (MI) in diabetic patients without cardiovascular disease(CVD) is comparable to the risk of MI in patients with CVD. We used a validated Markov model to compare the long-term costs and benefits of treating dyslipidemia in diabetic patients without CVD versus treating CVD patients without diabetes in the U.S. The generalizability and robustness of these results were also compared across six other countries (Canada, France,Germany, Italy, Spain, and the U.K.). RESEARCH DESIGN AND METHODS— With use of the Cardiovascular Disease Life Expectancy Model, cost effectiveness simulations of simvastatin treatment were performed for men and women who were 40-70 years of age and had dyslipidemia. We forecast the long-term risk reduction in CVD events after treatment. On the basis of the Scandinavian Simvastatin Survival Study results, we assumed a 35% reduction in LDL cholesterol and an 8% rise in HDL cholesterol. RESULTS— In the U.S., treatment with simvastatin for CVD patients without diabetes was cost-effective, with estimates ranging from$8,799 to $21,628 per year of life saved (YOLS). Among diabetic individuals without CVD, lipid therapy also appeared to be cost-effective, with estimates ranging from $5,063 to $23,792 per YOLS. In the other countries studied, the cost effectiveness of treating diabetes in the absence of CVD was comparable to the cost effectiveness of treating CVD in the absence of diabetes. CONCLUSIONS— Among diabetic men and women who do not have CVD,lipid therapy is likely to be as effective and cost-effective as treating nondiabetic individuals with CVD.
Synergistic effects of RXR and PPAR ligands to inhibit growth in human colon cancer cells phosphorylated RXR is a critical target for colon cancer management
Authors: K. Yamazaki, M. Shimizu, M. Okuno, R. Matsushima-Nishiwaki, N. Kanemura, H. Araki, H. Tsurumi, S. Kojima, I B. Weinstein, H. Moriwaki
Journal: Gut (2007)

<h3>Introduction</h3> Endovascular embolization for tumors and vascular malformations has emerged as an important preoperative adjunct prior to resection. We describe the advantages of utilizing a recently released dual lumen balloon catheter for ethylene vinyl alcohol copolymer, also known as Onyx (ev3, Irvine, California, USA), embolization for a variety of head and neck pathologies. <h3>Methods</h3> A retrospective review of all cases utilizing the Scepter C balloon catheter (MicroVention Inc, Tustin, California, USA) for use in balloon augmented embolization was performed over a 4 month period from October 2012 to February 2013 at the Medical University of South Carolina, Charleston, South Carolina, USA. Charts and angiographic images were reviewed. Representative cases involving diverse pathologies are summarized and illustrate the observed advantages of balloon augmented Onyx embolization with a dual lumen balloon catheter. <h3>Case illustrations</h3> Balloon augmented Onyx embolization utilizing a novel dual lumen balloon catheter was employed to treat both ruptured and unruptured arteriovenous malformations, intracranial dural arteriovenous fistulae, intracranial neoplasms, carotid body tumors, a thyroid mass, and an extracranial arteriovenous fistula. <h3>Conclusions</h3> The dual lumen balloon catheter has several advantages for use with Onyx embolization over older devices, including more efficient proximal plug formation and enhanced navigability for placement deep within the pedicles. The balloon augmented Onyx embolization technique represents a valuable tool to add to the armamentarium of the neurointerventionalist to address a variety of head and neck lesions.
Cost and Quality in the Use of Blood Bank Services for Normal Deliveries, Cesarean Sections, and Hysterectomies
Authors: R. Heather Palmer
Journal: JAMA (1986)

To reduce costs, preserve blood supplies, and enhance the safety of blood use during emergencies, the Department of Obstetrics and Gynecology and the blood bank at a teaching hospital recommended replacing pre-delivery crossmatch on selected patients with typing and screening for all patients undergoing normal or cesarean section delivery. Using an automated data system, it was shown that 75% and 50% reductions in the ordering of crossmatching for these two groups of patients promptly resulted, endured over a one-year follow-up period, and also spread to include patients undergoing hysterectomy. However, the cost of the increased use of typing and screening outweighed the reduced cost of crossmatching: actual annual costs increased by $11 151. We conclude that test-ordering practices can be changed surprisingly easily if a specific and reasonable policy is advocated by influential clinicians. However, changes in test use can cause unexpected cost increases. Only detailed study of practice patterns can reveal cost consequences for a specific institution.