tbuckley/cabot-search huggingface dataset:
Shared Decision-Making Reduces Drug Use and Psychiatric Severity in Substance-Dependent Patients
Authors: E.A.G. Joosten, C.A.J. de Jong, G.H. de Weert-van Oene, T. Sensky, C.P.F. van der Staak
Journal: Psychotherapy and Psychosomatics (2009)

&lt;i&gt;Background:&lt;/i&gt; In the last decades, shared decision-making (SDM) models have been developed to increase patient involvement in treatment decisions. The purpose of this study was to evaluate a SDM intervention (SDMI) for patients dependent on psychoactive substances in addiction health care programs. The intervention consisted of a structured procedure to reach a treatment agreement and comprised 5 sessions. &lt;i&gt;Methods:&lt;/i&gt; Clinicians in 3 treatment centres in the Netherlands were randomly assigned to the SDMI or a standard procedure to reach a treatment agreement. &lt;i&gt;Results:&lt;/i&gt; A total of 220 substance-dependent patients receiving inpatient treatment were randomised either to the intervention (n = 111) or control (n = 109) conditions. Reductions in primary substance use (F&lt;sub&gt;(1, 124)&lt;/sub&gt; = 248.38, p &lt; 0.01) and addiction severity (F&lt;sub&gt;(8)&lt;/sub&gt; = 27.76, p &lt; 0.01) were found in the total population. Significant change was found in the total population regarding patients’ quality of life measured at baseline, exit and follow-up (F&lt;sub&gt;(2, 146)&lt;/sub&gt; = 5.66, p &lt; 0.01). On the European Addiction Severity Index, SDMI showed significantly better improvements than standard decision-making regarding drug use (F&lt;sub&gt;(1, 164)&lt;/sub&gt; = 7.40, p &lt; 0.01) and psychiatric problems (F&lt;sub&gt;(1, 164)&lt;/sub&gt; = 5.91, p = 0.02) at 3-month follow-up. &lt;i&gt;Conclusion:&lt;/i&gt; SDMI showed a significant add-on effect on top of a well-established 3-month inpatient intervention. SDMI offers an effective, structured, frequent and well-balanced intervention to carry out and evaluate a treatment agreement.
Average Daily Blood Pressure, Not Office Blood Pressure, Is Associated With Progression of Cerebrovascular Disease and Cognitive Decline in Older People
Authors: William B. White, Leslie Wolfson, Dorothy B. Wakefield, Charles B. Hall, Patrick Campbell, Nicola Moscufo, Julia Schmidt, Richard F. Kaplan, Godfrey Pearlson, Charles R.G. Guttmann
Journal: Circulation (2011)

Background— High blood pressure (BP) is a risk factor for cerebrovascular disease, including stroke. Little is known about the importance of BP on the progression of microvascular disease of the brain, which has been associated with functional decline in mobility and cognition in older people. Methods and Results— This was a prospective cohort of subjects 75 to 89 years of age to determine relations among vascular risk factors, white matter hyperintensity volume, and functional status. Ninety-nine subjects were enrolled through the use of a balanced 3×3 matrix stratified by age and mobility performance, and 72 subjects completed all sets of baseline and follow-up studies at 2 years. Subjects were excluded if there were medications or systemic or neurological diseases that could compromise mobility. Ambulatory and clinic BP monitoring, magnetic resonance imaging, gait studies, and neuropsychological testing were performed at baseline and after 24 months. Brain classification into normal white matter and T2-hyperintense white matter hyperintensity volume was performed with semiautomated segmentation. Quantitative measures of mobility and cognitive function were obtained longitudinally. Increased ambulatory systolic BP, but not clinic systolic BP, from baseline to 24 month follow-up was associated with increased white matter hyperintensity volume over that same period, as well as measures of executive function/processing speed. Similar associations were observed for 24-hour BP, awake BP, and sleep BP but not for the surge between the sleep and awake time at the 24-month time point. Conclusions— These data demonstrate for the first time the importance of 24-hour systolic BP in the progression of brain white matter hyperintensity volume burden associated with impairment of cognitive function in older people. The 24-hour systolic BP may be a potential target for intervention in the elderly to reduce vascular disease of the brain and impairment of function.
Daily Aspirin Use and Cancer Mortality in a Large US Cohort
Authors: E. J. Jacobs, C. C. Newton, S. M. Gapstur, M. J. Thun
Journal: JNCI Journal of the National Cancer Institute (2012)

A recent pooled analysis of randomized trials of daily aspirin for prevention of vascular events found a substantial reduction (relative risk [RR] = 0.63, 95% confidence interval [CI] = 0.49 to 0.82) in overall cancer mortality during follow-up occurring after 5 years on aspirin. However, the magnitude of the effect of daily aspirin use, particularly long-term use, on cancer mortality is uncertain. We examined the association between daily aspirin use and overall cancer mortality among 100 139 men and women with no history of cancer in the Cancer Prevention Study II Nutrition Cohort. Cox proportional hazards regression models were used to estimate multivariable-adjusted relative risks (RRs) and 95% confidence intervals (CIs). Between 1997 and 2008, 5138 participants died from cancer. Compared with no use, daily aspirin use at baseline was associated with slightly lower cancer mortality, regardless of duration of daily use (for <5 years of use, RR = 0.92, 95% CI = 0.85 to 1.01; for ≥5 years of use, RR = 0.92, 95% CI = 0.83 to 1.02). Associations were slightly stronger in analyses that used updated aspirin information from periodic follow-up questionnaires and included 3373 cancer deaths (for <5 years of use, RR = 0.84, 95% CI = 0.76 to 0.94; for ≥5 years of use, RR = 0.84, 95% CI = 0.75 to 0.95). These results are consistent with an association between recent daily aspirin use and modestly lower cancer mortality but suggest that any reduction in cancer mortality may be smaller than that observed with long-term aspirin use in the pooled trial analysis.
Improved Oral Anticoagulation After a Dietary Vitamin K–Guided Strategy
Authors: Michelli C. de Assis, Eneida R. Rabelo, Christiane W. Ávila, Carisi Anne Polanczyk, Luis E. Rohde
Journal: Circulation (2009)

Dietary vitamin K is thought to be an important factor that interferes with anticoagulation stability, but the clinical applicability of this interaction has not been evaluated adequately in prospective studies.In a randomized controlled trial that enrolled outpatients with a recent international normalized ratio (INR) outside the therapeutic target, we compared 2 strategies to optimize long-term oral anticoagulation: (1) a conventional approach based on changes in anticoagulant prescription and (2) a dietary vitamin K-guided strategy based on simple modifications of the amount of vitamin K-rich foods ingested per week. The primary efficacy end point was the percentage of patients who achieved a prespecified INR target at 90 days after randomization. Study population (n=132) predominantly included men with mechanical heart prostheses (58%) or atrial fibrillation (35%). Over time, patients allocated to the vitamin K-guided strategy reached the prespecified INR more frequently so that after 90 days of follow-up, 74% were on target compared with 58% of patients managed conventionally (P=0.04). Patients allocated to the dietary vitamin K-guided strategy had the same magnitude and direction of INR variation as those observed with the conventional approach in the short term (15 days) for both underanticaogulated and overanticoagulated patients. Minor bleeding or use of parenteral vitamin K were also marginally less frequent in patients managed according to the dietary intervention (1 [1.5%] versus 7 [11%]; P=0.06).A vitamin K-guided management strategy to adjust long-term oral anticoagulation is feasible and safe and may result in an increased chance of reaching target levels of INR.
JE mRNA accumulates rapidly in aortic injury and in platelet-derived growth factor-stimulated vascular smooth muscle cells.
Authors: M B Taubman, B J Rollins, M Poon, J Marmur, R S Green, B C Berk, B Nadal-Ginard
Journal: Circulation Research (1992)

The early response to vascular injury is characterized by migration of inflammatory cells, including monocytes, and platelets to the damaged vessel wall. These inflammatory cells may serve as a source of growth factors and cytokines that stimulate vascular smooth muscle cell (VSMC) migration and proliferation associated with intimal hyperplasia. JE is a platelet-derived growth factor (PDGF)-inducible "early" gene that encodes a monocyte chemoattractant and, as such, could play an important role in inflammation. We now report that JE mRNA levels are increased in intact aorta after balloon injury. The time course of this increase, with maximal levels at 4 hours, is similar to that seen in PDGF-treated cultured rat aortic VSMCs. The accumulation of JE mRNA in cultured VSMCs is accompanied by a marked increase in the secretion of JE protein. The elevation of JE mRNA levels in VSMCs shows specificity for PDGF, because angiotensin II, alpha-thrombin, and epidermal growth factor fail to increase JE mRNA levels. In contrast to 3T3 fibroblasts, the accumulation of JE mRNA in VSMCs in response to PDGF is predominantly due to an increase in JE mRNA stability. The accumulation of JE mRNA in VSMCs stimulated by PDGF appears to occur via a novel pathway(s) independent of Ca2+ mobilization, Na(+)-H+ exchange, protein kinase C activation, or elevation in cAMP levels. These findings suggest that VSMCs may take part in the early inflammatory response after injury through the production of JE, a potent monocyte chemoattractant. Finally, our data suggest that JE may be a marker for PDGF-specific effects on VSMCs, both in vitro and in vivo. Thus, in addition to direct effects on VSMC growth and migration, PDGF may play a role in the early inflammatory response after vascular injury by inducing chemoattractants, such as that encoded by JE.
Domiciliary liquid oxygen versus concentrator treatment in chronic hypoxaemia: a cost-utility analysis
Authors: A Andersson, K Strom, H Brodin, M Alton, G Boman, P Jakobsson, A Lindberg, M Uddenfeldt, H Walter, LA Levin
Journal: European Respiratory Journal (1998)

Whether long-term oxygen therapy (LTOT) improves quality of life in chronic hypoxaemia has been questioned. LTOT with an oxygen concentrator (C/C) and gas cylinders for ambulation is considered cumbersome compared to mobile liquid oxygen equipment (L). The hypothesis for this study was that LTOT with liquid oxygen treatment (L) improves patients' health-related quality of life, but that it is also more expensive compared to concentrator (C/C) treatment. A prospective, randomized multicentre trial comparing C/C with L for LTOT was conducted during a six-month period. Fifty-one patients (29 on L and 22 on C/C) with chronic hypoxaemia, regularly active outside the home, participated in the study initially. Costs for oxygen were obtained from the pharmacies. Patient diaries and telephone contacts with members of the healthcare sector were used to estimate costs. Health-related quality of life was measured by the Sickness Impact Profile (SIP) and the EuroQol, instruments at the start and after 6 months. The average total cost per patient for group C/C for the six-month period was US$1,310, and for group L it was US$4,950. Health-related quality of life measured by the SIP instrument showed significant differences in favour of group L in the categories/dimensions of physical function, body care, ambulation, social interaction and total SIP score. In conclusion, liquid-oxygen treatment was more expensive compared to concentrator treatment. However, treatment effects showed that liquid oxygen had a better impact on quality of life.
Non–Contrast-Enhanced Computerized Tomography and Analgesic-Related Kidney Disease
Authors: William L. Henrich, Richard L. Clark, Judith P. Kelly, Vardaman M. Buckalew, Andrew Fenves, William F. Finn, Joseph I. Shapiro, Paul L. Kimmel, Paul Eggers, Larry E. Agodoa, George A. Porter, Samuel Shapiro, Robert Toto, Theresa Anderson, L. Adrienne Cupples, David W. Kaufman
Journal: Journal of the American Society of Nephrology (2006)

Previous studies suggested that the non-contrast-enhanced computerized tomography (CT) scan is a highly reliable tool for the diagnosis of analgesic-associated renal disease. However, this issue has not been addressed in the US population. A total of 221 incident patients with ESRD from different regions of the United States underwent a helical CT scan and detailed questioning about drug history. Specific renal anatomic criteria were developed to determine whether a constellation of CT findings (small indented calcified kidneys [SICK]) is linked to analgesic ingestion. For approximating use before the onset of renal disease, only analgesic ingestion at least 9 yr before starting dialysis was considered relevant. Fifteen patients met the criteria for SICK. This represented 7% of the enrolled patients and approximately 1% of the total ESRD population. There was a significant increase in the estimated risk among patients with a history of heavy aspirin ingestion (odds ratio [OR] 7.4 [95% confidence interval (CI) 1.2 to 43] for > or =1 kg lifetime; OR 8.8 [95% CI 1.2 to 66] for > or =0.3 kg/yr). Total analgesic ingestion of > or =0.3 kg/yr also was significantly associated with SICK (OR 8.2; 95% CI 1.5 to 45). These findings were accounted for largely by combination products that contained aspirin and phenacetin (used by three patients with SICK), which are no longer available. In addition, the CT finding of SICK was present only in a minority of heavy analgesic users, yielding a sensitivity of 5 to 26%. Findings of SICK are infrequent in the US ESRD population and do not occur among a sufficient proportion of heavy analgesic users to render the non-contrast-enhanced CT scan a sensitive tool to detect analgesic-associated kidney injury.
Altered gene expression profiles in nasal respiratory epithelium reflect stable versus acute childhood asthma
Authors: Jesus R. Guajardo, Kathleen W. Schleifer, Michael O. Daines, Richard M. Ruddy, Bruce J. Aronow, Marsha Wills-Karp, Gurjit K. Khurana Hershey
Journal: Journal of Allergy and Clinical Immunology (2004)
Efficacy and Toxicity Management of 19-28z CAR T Cell Therapy in B Cell Acute Lymphoblastic Leukemia
Authors: Marco L. Davila, Isabelle Riviere, Xiuyan Wang, Shirley Bartido, Jae Park, Kevin Curran, Stephen S. Chung, Jolanta Stefanski, Oriana Borquez-Ojeda, Malgorzata Olszewska, Jinrong Qu, Teresa Wasielewska, Qing He, Mitsu Fink, Himaly Shinglot, Maher Youssif, Mark Satter, Yongzeng Wang, James Hosey, Hilda Quintanilla, Elizabeth Halton, Yvette Bernal, Diana C. G. Bouhassira, Maria E. Arcila, Mithat Gonen, Gail J. Roboz, Peter Maslak, Dan Douer, Mark G. Frattini, Sergio Giralt, Michel Sadelain, Renier Brentjens
Journal: Science Translational Medicine (2014)

CD19 CAR T cell therapy induces complete remissions in 88% of 16 adult patients with relapsed or refractory acute lymphoblastic leukemia.
Adjuvant chemotherapy after preoperative (chemo)radiotherapy and surgery for patients with rectal cancer: a systematic review and meta-analysis of individual patient data
Authors: Anne J Breugom, Marloes Swets, Jean-François Bosset, Laurence Collette, Aldo Sainato, Luca Cionini, Rob Glynne-Jones, Nicholas Counsell, Esther Bastiaannet, Colette B M van den Broek, Gerrit-Jan Liefers, Hein Putter, Cornelis J H van de Velde
Journal: The Lancet Oncology (2015)
Myeloablative immunosuppressive treatment with autologous haematopoietic stem cell transplantation in a patient with psoriatic arthropathy and monoclonal gammopathy of undetermined significance
Authors: M Mohren
Journal: Annals of the Rheumatic Diseases (2004)

Transplantation of peripheral blood stem cells (PBSCT) is currently explored in patients with refractory autoimmune diseases,1,2 and results so far show that about two thirds of patients who receive a transplant benefit from this procedure.3 Transplant related mortality in patients with autoimmune disease is similar to that seen in patients with non-Hodgkin’s lymphoma.4

We report on a 34 year old male patient with a 16 year history of psoriatic arthropathy with mutilating bilateral lesions of the wrists, metacarpal, proximal and distal interphalangeal and metatarsal, and lower extremity interphalangeal joints, who was refractory to treatment with multiple disease modifying, immunosuppressive substances, including gold, methotrexate (MTX), MTX plus sulfasalazine, cyclosporin A (CSA), mycophenolate mofetil (MMF) alone or in combination with CSA, steroids, and a combination of CSA, MTX, and MMF. IgA κ monoclonal gammopathy of unknown significance developed later in the course of …
Who Cares about Preventing Acute Respiratory Distress Syndrome?
Authors: Gordon D. Rubenfeld
Journal: American Journal of Respiratory and Critical Care Medicine (2014)

Acute respiratory distress syndrome (ARDS) is a common, lethal, and morbid respiratory complication primarily seen in the setting of major trauma and infection. Despite advances in mechanical ventilation for ARDS, many interventions have not been successful in reducing mortality. Recent grant announcements and ongoing clinical trials indicate an interest in preventing ARDS. This Perspective challenges some of the basic assumptions of ARDS prevention and preventive care in the intensive care unit. ARDS is an organ function surrogate outcome. Studies of surrogate outcomes in medicine have repeatedly failed to show an association with patient-centered outcomes that might include mortality, quality of life, patient satisfaction, and cost. Organ failure surrogate outcomes in critical care, including oxygenation, cardiac output, and blood pressure, have similarly failed to show a consistent association with patient-centered benefit. Trials designed to demonstrate an effect on surrogate outcomes will rarely be able to demonstrate small, but important, harms so that the net benefit of prevention can be calculated. This will leave clinicians with insufficient information to balance the unknown benefits of ARDS prevention with imprecisely estimated costs or risks of prevention. Because ARDS diagnosis relies on oxygenation and the chest radiograph that might be directly influenced by the prophylactic intervention, studies must be designed to insure that the prevention is not merely cosmetic. Strategies that prevent ARDS need to be tested in trials sufficiently powered to demonstrate their patient-centered costs, benefits and harms before widespread adoption.
Relapse Following Treatment Withdrawal in Patients with Autoimmune Chronic Active Hepatitis
Authors: John E. Hegarty, Kayhan T. Nouri Aria, Bernard Portmann, Adrian L. W. F. Eddleston, Roger Williams
Journal: Hepatology (1983)

A prospective study was performed to evaluate the outcome of treatment withdrawal in 30 patients with "autoimmune" chronic active hepatitis in remission for periods of 1.5 to 9 years on maintenance corticosteroid and azathioprine therapy. Reactivation of disease, with marked rises in serum aminotransferase level (mean 668 +/- S.D. 458 IU per liter) and accompanied by severe symptoms, occurred in 25 (87%) patients within 52 weeks (median 9 weeks; range 5 to 52) and was associated with the histological features of piecemeal necrosis and lobular hepatitis in all 20 liver biopsies examined. Age, sex, duration of disease and remission, presence of cirrhosis, autoantibody status, or immunoglobulin levels did not differentiate patients who relapsed from those who remained in remission. The response to reinstitution of treatment with prednisolone was satisfactory in 25 patients and clinical and biochemical abnormalities resolved within 10 weeks (median 6; range 3 to 10), death occurred in one patient within 48 hr of readmission to hospital.
Identification and Referral to Improve Safety (IRIS) of women experiencing domestic violence with a primary care training and support programme: a cluster randomised controlled trial
Authors: Gene Feder, Roxane Agnew Davies, Kathleen Baird, Danielle Dunne, Sandra Eldridge, Chris Griffiths, Alison Gregory, Annie Howell, Medina Johnson, Jean Ramsay, Clare Rutterford, Debbie Sharp
Journal: The Lancet (2011)
Virulence of Cryptococcus neoformans. Regulation of capsule synthesis by carbon dioxide.
Authors: D L Granger, J R Perfect, D T Durack
Journal: Journal of Clinical Investigation (1985)

Cryptococcus neoformans is variably encapsulated in vitro, whereas in tissues it develops a large capsule. We observed that cells of a strain with thin capsules, when growing in a standard fungal culture medium, became heavily encapsulated when incubated in serum-free cell culture medium (Dulbecco's modified Eagle's medium [DME]). Capsule size was quantitated physically by measuring cell volume, and chemically by determining the content of a capsular monosaccharide, glucuronate. The CO2/HCO-3 couple stimulated capsule development, resulting in visible enlargement by 3 h after exposure to high CO2/HCO-3. The amount of capsule per cell was directly proportional to the total millimolar CO2/HCO-3 concentration between 24 and 2.4 mM at pH 7.35, but at constant PCO2 (40 torr) and varying [HCO-3], the cells were heavily encapsulated down to pH 6.8. Concentration of CO2/HCO-3 in the physiologic range increased elaboration of polysaccharide into the medium and slowed the cell generation time from 2 to 6 h. Four other first-passage clinical isolates were all heavily encapsulated in DME with CO2/HCO-3, but variably encapsulated in DME without CO2/HCO-3. Exposure of yeast to increased CO2/HCO-3 caused a marked reduction in complement-mediated phagocytosis by mouse macrophages. A stable clone was isolated which contained capsular polysaccharide, but lacked the CO2-inducible phenotype. This clone was avirulent for steroid-treated rabbits. Thus, the prevailing CO2 concentration in mammalian tissues may be one stimulus for capsular polysaccharide synthesis. This could serve as an adaptive mechanism favoring parasite survival in the host.
Viral interleukin 10 is critical for the induction of B cell growth transformation by Epstein-Barr virus.
Authors: I Miyazaki, R K Cheung, H M Dosch
Journal: The Journal of Experimental Medicine (1993)

We have used an efficient cDNA subtraction library procedure to identify newly induced genes in human B lymphocytes infected for 6 h with Epstein-Barr virus (EBV). Among the genes identified by automated sequencing of a random subset of clones from this library, one coded the EBV BCRF1 open reading frame, which specifies the viral interleukin 10 gene (vIL-10). This molecule is highly homologous to human (h)IL-10 and was previously thought to represent a "late" viral gene expressed only during the lytic phase of virus replication. Using gene amplification by reverse transcriptase polymerase chain reaction of B cell RNA obtained at varying times after infection, we detected vIL-10 expression within a few hours of EBV infection, followed, 20-30 h later by expression of hIL-10. Expression of both genes continued beyond the initial transformation phase (5-10 d) and was present in all transformed cell lines tested. When added at the time of viral infection, antisense (but not sense) oligonucleotides for vIL-10 mRNA (cytosolic half-life, approximately 6 h) prevented subsequent B cell transformation. The antisense effect was highly specific, leaving the expression levels of other transformation-related genes intact. Addition of exogenous (h)IL-10 rescued the transformation process in antisense-treated cells. Our observations establish vIL-10 as a new latency gene with a directly transformation-prerequisite function.