tbuckley/cabot-search huggingface dataset:
Upper digestive bleeding in cirrhosis. Post-therapeutic outcome and prognostic indicators
Authors: Gennaro D'Amico, Roberto De Franchis
Journal: Hepatology (2003)

Several treatments have been proven to be effective for variceal bleeding in patients with cirrhosis. The aim of this multicenter, prospective, cohort study was to assess how these treatments are used in clinical practice and what are the posttherapeutic prognosis and prognostic indicators of upper digestive bleeding in patients with cirrhosis. A training set of 291 and a test set of 174 bleeding cirrhotic patients were included. Treatment was according to the preferences of each center and the follow–up period was 6 weeks. Predictive rules for 5–day failure (uncontrolled bleeding, rebleeding, or death) and 6–week mortality were developed by the logistic model in the training set and validated in the test set. Initial treatment controlled bleeding in 90% of patients, including vasoactive drugs in 27%, endoscopic therapy in 10%, combined (endoscopic and vasoactive) in 45%, balloon tamponade alone in 1%, and none in 17%. The 5–day failure rate was 13%, 6–week rebleeding was 17%, and mortality was 20%. Corresponding findings for variceal versus nonvariceal bleeding were 15% versus 7% ( P = .034), 19% versus 10% ( P = .019), and 20% versus 15% ( P = .22). Active bleeding on endoscopy, hematocrit levels, aminotransferase levels, Child–Pugh class, and portal vein thrombosis were significant predictors of 5–day failure; alcohol–induced etiology, bilirubin, albumin, encephalopathy, and hepatocarcinoma were predictors of 6–week mortality. Prognostic reassessment including blood transfusions improved the predictive accuracy. All the developed prognostic models were superior to the Child–Pugh score. In conclusion, prognosis of digestive bleeding in cirrhosis has much improved over the past 2 decades. Initial treatment stops bleeding in 90% of patients. Accurate predictive rules are provided for early recognition of high–risk patients.
A Prospective Study of Soluble Tumor Necrosis Factor-α Receptor II (sTNF-RII) and Risk of Coronary Heart Disease Among Women With Type 2 Diabetes
Authors: Iris Shai, Matthias B. Schulze, JoAnn E. Manson, Kathryn M. Rexrode, Meir J. Stampfer, Christos Mantzoros, Frank B. Hu
Journal: Diabetes Care (2005)

OBJECTIVE—Tumor necrosis factor-α (TNF-α), a cytokine secreted by adipose tissue and other cells, might play a role in insulin resistance. RESEARCH DESIGN AND METHODS—Of 32,826 women from the Nurses’ Health Study who provided blood at baseline, we followed 929 women with type 2 diabetes. During 10 years of follow-up, we documented 124 incident cases of coronary heart disease (CHD). RESULTS—After adjustment for age, smoking, BMI, and other cardiovascular risk factors, the relative risks (RRs) comparing extreme quartiles of soluble TNF-α receptor II (sTNF-RII) were 2.48 (95% CI 1.08–5.69; P = 0.034) for myocardial infarction (MI) and 2.02 (1.17–3.48; P = 0.003) for total CHD. The probability of developing CHD over 10 years was higher among diabetic subjects with substantially higher levels of both sTNF-RII (&amp;gt;75th percentile) and HbA1c (&amp;gt;7%), compared with diabetic subjects with lower levels (25% vs. 7%, P &amp;lt; 0.0001). Diabetic subjects with only higher sTNF-RII or HbA1c had similar (16–17%) risk. In a multivariate model, diabetic subjects with higher levels of both sTNF-RII and HbA1c had an RR of 3.66 (1.85–7.22) for MI and 3.03 (1.82–5.05) for total CHD, compared with those with lower levels of both biomarkers. CONCLUSIONS—Increased levels of sTNF-RII were strongly associated with risk of CHD among diabetic women, independent of hyperglycemia.
ALLOANTISERUM-INDUCED INHIBITION OF MIGRATION INHIBITION FACTOR PRODUCTION IN IMMUNE RESPONSE GENE-CONTROLLED IMMUNE SYSTEMS
Authors: Shlomo Z. Ben-Sasson, Ethan Shevach, Ira Green, William E. Paul
Journal: The Journal of Experimental Medicine (1974)

We have previously demonstrated that alloantisera prepared by reciprocal immunization of strain 2 and strain 13 guinea pigs specifically block stimulation of in vitro DNA synthesis in genetically controlled systems. In order to determine whether this blockade extends to other T-lymphocyte functions, we examined the effect of alloantisera on the production of migration inhibition factor (MIF). (2 x 13)F(1) guinea pigs were immunized with a DNP derivative of the copolymer of L-glutamic acid and L-lysine (DNP-GL) and with DNP guinea pig albumin (GPA). The response to the former is controlled by a 2-linked Ir gene while that to the latter is mainly controlled by a 13-linked Ir gene. MIF production was assayed by an indirect procedure in which the migrating cell population lacked the histocompatibility antigen against which the alloantiserum was directed. Our results showed that anti-2 serum blocked MIF production by F(1) cells in response to DNP-GL but not DNP-GPA while anti-13 serum had the opposite effect. These experiments show that expression of a second major T-cell function is specifically blocked by alloantisera and suggest that Ir-gene products may act as antigen recognition substances on more than one type of T cell.
The<i>in vivo</i>apoptotic effect of interferon alfa-2b on rat preneoplastic liver involves Bax protein
Authors: María de Luján Alvarez, Juan Pablo Cerliani, Juan Monti, Cristina Carnovale, María Teresa Ronco, Gerardo Pisani, María Cristina Lugano, María Cristina Carrillo
Journal: Hepatology (2002)

To determine whether interferon alfa (IFN-α) prevents in vivo oncogenesis in very-early-stage cancer cells, we evaluated the action of IFN-α2b over preneoplastic foci in rats. Animals were divided into 6 groups: subjected to a 2-phase model (diethylnitrosamine [DEN] plus 2-acetylaminofluorene [2-AAF]) of preneoplasia development (group 1), treated with IFN-α2b during the 2 phases (group 2), only during initiation with DEN (group 3), only during administration of 2-AAF (group 4), subjected only to an initiation stage (group 5), and treated with IFN-α2b during this period (group 6). The numbers of placental form of rat glutathione S-transferase (rGST-P)-positive foci per liver and the foci as percentage of liver were significantly reduced in groups 2, 3, and 6 but not in group 4. Rats treated with IFN-α2b showed a higher apoptotic index (AI) in altered hepatic foci (AHF). Levels of p53 and Bax protein in liver lysates were significantly increased in those animals. Similarly, levels of antiapoptotic proteins Bcl-2 and Bcl-x L in mitochondrial fraction were decreased. Finally, increased levels of Bax protein were localized in the mitochondria of rats that received IFN-α2b, at least during the DEN phase (groups 2, 3, and 6), whereas mitochondrial Bax expression was not increased in group 4. In conclusion, the preneoplastic hepatocytes in rats that received IFN-α2b during the initiation stage undergo programmed cell death as a primary result of a significant increase in the amount and translocation to the mitochondria of Bax protein.
Conduction through a Narrow Isthmus in Isolated Canine Atrial Tissue
Authors: DOMINGO DE LA FUENTE, BETTY SASYNIUK, G. K. MOE
Journal: Circulation (1971)

Isolated blocks of dog atrial tissue were dissected to provide a narrow isthmus connecting two broader areas. Unidirectional block was readily demonstrable at the junctions of the narrow band with the larger areas. Transmembrane action potentials just proximal to the blocked junction were abbreviated, while only local electronic potentials were recorded beyond. Acetylcholine restored 1:1 propagation in blocked preparations. The model may explain some of the features of intermittent preexcitation.
Dietary supplementation with L-arginine ameliorates glomerular hypertension in rats with subtotal nephrectomy.
Authors: T Katoh, K Takahashi, S Klahr, A A Reyes, K F Badr
Journal: Journal of the American Society of Nephrology (1994)

This study was designed to examine the potential effect(s) of dietary supplementation with L-arginine on the renal microcirculation of female Munich-Wistar rats with ablation of 60 to 70% of total renal mass. All rats were fed a standard rat chow containing 22.8% protein (1.42% L-arginine). Groups 1 (N = 6) and 3 (N = 7) drank tap water and had micropuncture studies after 5 to 6 or 15 to 16 wk, respectively, of subtotal renal ablation. Groups 2 (N = 5) and 4 (N = 7) drank tap water supplemented with L-arginine (1%) and had micropuncture studies after 5 to 6 or 15 to 16 wk, respectively, of subtotal renal ablation. Glomerular micropuncture studies revealed no differences in any of the parameters of glomerular hemodynamics measured 5 to 6 wk after renal ablation (Groups 1 versus 2). However, by 15 to 16 wk postnephrectomy, values of glomerular capillary pressure and efferent arteriolar resistance were significantly greater and the glomerular capillary ultrafiltration coefficient was significantly lower in rats drinking tap water than in rats drinking tap water supplemented with L-arginine. Single-nephron GFR, single-nephron plasma flow rate, and afferent arteriolar resistance were not different between these two groups. The data suggest that the long-term administration of L-arginine prevents the progression of glomerular sclerosis in rats with subtotal nephrectomy, at least in part, by ameliorating glomerular capillary hypertension.
Adverse Events in Connective Tissue Disease–Associated Pulmonary Arterial Hypertension
Authors: Rennie L. Rhee, Nicole B. Gabler, Amy Praestgaard, Peter A. Merkel, Steven M. Kawut
Journal: Arthritis & Rheumatology (2015)

Patients with connective tissue disease (CTD)-associated pulmonary arterial hypertension (PAH) have a poorer prognosis compared to those with idiopathic PAH, but little is known about the differences in treatment-related adverse events (AEs) and serious adverse events (SAEs) between these groups. This study was undertaken to characterize these differences.Individual patient-level data from 10 randomized controlled trials of therapies for PAH were obtained from the US Food and Drug Administration. Patients diagnosed as having either CTD-associated PAH or idiopathic PAH were included. A treatment-by-diagnosis interaction term was used to examine whether the effect of treatment on occurrence of AEs differed between patients with CTD-associated PAH and those with idiopathic PAH. Studies were pooled using fixed-effect models.The study sample included 2,370 participants: 716 with CTD-associated PAH and 1,654 with idiopathic PAH. In the active treatment group compared to the placebo group, the risk of AEs was higher among patients with CTD-associated PAH than among those with idiopathic PAH (odds ratio [OR] 1.57, 95% confidence interval [95% CI] 1.00-2.47 versus OR 0.94, 95% CI 0.69-1.26; P for interaction = 0.061), but there was no difference in the risk of SAEs in analyses adjusted for age, race, sex, hemodynamic findings, and laboratory values. Despite the higher occurrence of AEs in patients with CTD-associated PAH assigned to active therapy compared to those receiving placebo, the risk of drug discontinuation due to an AE was similar to that in patients with idiopathic PAH assigned to active therapy (P for interaction = 0.27).Patients with CTD-associated PAH experienced more treatment-related AEs compared to those with idiopathic PAH in therapeutic clinical trials. These findings suggest that the overall benefit of advanced therapies for PAH may be attenuated by the greater frequency of AEs.
How Many People Are Malnourished?
Authors: Peter Svedberg
Journal: Annual Review of Nutrition (2011)

The present article reviews the strengths and weaknesses of the three main methods for estimating the prevalence of malnutrition in populations: self-reported hunger, estimates based on food supplies, and anthropometrics. Although far from flawless, anthropometrics is found to be the most reliable method and also the most useful for directing policy. The main form of malnutrition among adults is overweight, not only in developed countries, but also in almost all developing countries. Only in a few developing countries is adult underweight more prevalent. By the conventional anthropometric indicators, about one-quarter of all children below the age of 5 in the developing countries are stunted or underweight, and about 10% are wasted. The total burden of malnutrition among young children, as measured by the Composite Index of Anthropometric Failure, is considerably higher, about 60% in India, the country with the largest child population in the world.
Transendothelial transport and metabolism of adenosine and inosine in the intact rat aorta.
Authors: K Kroll, M K Kelm, K F Bürrig, J Schrader
Journal: Circulation Research (1989)

This study was aimed at defining the role of vascular endothelium in the transport and metabolism of adenosine. For this purpose, endothelium-intact and endothelium-denuded isolated rat aortas, perfused at constant flow (2 ml/min), were prelabeled with 3H-adenosine or 3H-inosine for 10 minutes at concentrations of 0.012-100 microM. Sequestration of adenosine by endothelium was determined from radioactivity recovered during selective endothelial cell removal with deoxycholic acid (0.75% for 15 seconds). In the physiological concentration range of adenosine (0.012-1 microM), fractional sequestration by endothelium was 90-92% of the total adenosine incorporation by the aorta. Endothelial sequestration of inosine at 0.1 microM was 85%. At 100 microM adenosine or inosine, fractional sequestration by aortic endothelium was 33% and 39%, respectively. Analysis of the specific radioactivity of adenine nucleotides extracted from prelabeled aortas indicated that most of the adenosine was incorporated into endothelial adenine nucleotides. Incorporation of inosine into endothelial ATP was approximately 15% that of adenosine. Inhibition of aortic adenosine deaminase with erythro-9-(2-hydroxy-3-nonyl)adenine (EHNA) did not influence sequestration of 0.1 microM adenosine, but resulted in a 49% reduction of total endothelial incorporation at 100 microM adenosine. Transfer of radioactive purines from the endothelium to underlying smooth muscle after prelabeling was equivalent to only 1%/hr of total endothelial radioactivity. Our findings suggested that 1) macrovascular endothelium of the aorta constitutes a highly effective metabolic barrier for circulating adenosine and inosine; 2) transfer of labeled adenine nucleotides from endothelium to underlying smooth muscle is rather small and most likely proceeds via dephosphorylated purine compounds; and 3) measurement of adenosine trapping in endothelial and smooth muscle compartments overestimates the transendothelial adenosine concentration gradient.
Academic Mentoring—How to Give It and How to Get It
Authors: Allan S. Detsky, Mark Otto Baerlocher
Journal: JAMA (2007)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Immunotherapy using IL-2 potentially reverse disorders of Th1 /Th17 response in patients with MDR-TB
Authors: Qi Tan, Rui Min, Hong Wang, Wei-Ping Xie, Zhi-Hui Xu, Mao Huang, Wei-Guo Xu
Journal: European Respiratory Journal (2013)

Objective: Prevalence of multidrug-resistant tuberculousis(MDR-TB) worldwide today is urgent. Dysregulation of Th1/Th17 was associated with the pathogenesis and the clinical outcome of MDR-TB infection. Adjunctive immunotherapy with IL-2 evidently enhanced the immune response in mouse model of TB infection .This clinical study investigated the therapeutic effects of Recombinant Human Interleukin-2(rhIL-2) co-administrated with optimized antituberculosis chemotherapy. Methods: We examined Th17 cells and Th1 cells by flow cytometry in peripheral blood of 18 healthy subjects(HCs),16 drug-sensitive TB patients(DS-TBs)and 26 MDR-TB patients(13 using optimized antituberculosis chemotherapy,13 using rhIL-2 plus optimized antituberculosis chemotherapy). Results: We found downregulated Th1 and upregulated Th17 expression in MDR-TBs before treatment. After 7-month treatment, patients using rhIL-2 plus chemotherapy showed more remarkble higher Th1 cell expression than that in patients with chemotherapy .All the MDR-TBs after 7-month treatment showed downregulated Th17 cell expression ,the downregulation in patients after rhIL-2 plus chemotherapy was more significant and normalized to that in HCs.

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Conclusions: These data provided evidence that immunotherapy with rhIL-2 reverse the disorders of Th1 /Th17 activation in MDR-TB infection,which may promote an enhanced antimicrobial response to improve outcomes in MDR-TB patients.

 [1]: pending:yes
Prospective Study of 2-[<sup>18</sup>F]Fluorodeoxyglucose Positron Emission Tomography in the Assessment of Regional Nodal Spread of Disease in Patients With Breast Cancer: An Ontario Clinical Oncology Group Study
Authors: Kathleen I. Pritchard, Jim A. Julian, Claire M.B. Holloway, David McCready, Karen Yvonne Gulenchyn, Ralph George, Nicole Hodgson, Peter Lovrics, Francisco Perera, Leela Elavathil, Frances P. O'Malley, Nancy Down, Audley Bodurtha, Wendy Shelley, Mark N. Levine
Journal: Journal of Clinical Oncology (2012)

Purpose 2-[ 18 F]fluorodeoxyglucose (FDG) positron emission tomography (PET) is potentially useful in assessing lymph nodes and detecting distant metastases in women with primary breast cancer. Patients and Methods Women diagnosed with operable breast cancer within 3 months underwent FDG-PET at one of five Ontario study centers followed by axillary lymph node assessment (ALNA) consisting of sentinel lymph node biopsy (SLNB) alone if sentinel lymph nodes (SLNs) were negative, SLNB with axillary lymph node dissection (ALND) if SLNB or PET was positive, or ALND alone if SLNs were not identified. Results Between January 2005 and March 2007, 325 analyzable women entered this study. Sentinel nodes were found for 312 (96%) of 325 women and were positive for tumor in 90 (29%) of 312. ALND was positive in seven additional women. Using ALNA as the gold standard, sensitivity for PET was 23.7% (95% CI, 15.9% to 33.6%), specificity was 99.6% (95% CI, 97.2% to 99.9%), positive predictive value was 95.8% (95% CI, 76.9% to 99.8%), negative predictive value was 75.4% (95% CI, 70.1% to 80.1%), and prevalence was 29.8% (95% CI, 25.0% to 35.2%). Using logistic regression, tumor size was predictive for prevalence of tumor in the axilla and for PET sensitivity. PET scan was suspicious for distant metastases in 13 patients; three (0.9%) were confirmed as metastatic disease and 10 (3.0%) were false positive. Conclusion FDG-PET is not sufficiently sensitive to detect positive axillary lymph nodes, nor is it sufficiently specific to appropriately identify distant metastases. However, the very high positive predictive value (96%) suggests that PET when positive is indicative of disease in axillary nodes, which may influence surgical care.
What<i>DSM-5</i>Could Mean to Children With Autism and Their Families
Authors: Neal Halfon, Alice A. Kuo
Journal: JAMA Pediatrics (2013)

The American Psychiatric Association will update its Diagnostic and Statistical Manual of Mental Disorders to its fifth edition (DSM-5). With this new edition, the classification and diagnostic criteria for the spectrum of autistic disorders will change and become more specific and potentially more restrictive. Rather than maintaining several subcategories of autism including Asperger syndrome, there will be one new category called autism spectrum disorder. This change may alter which children are diagnosed as having autism as well as modify eligibility for treatment, educational, and other support services. We review the history and rationale for the proposed changes as well as several recent studies that have attempted to gauge the impact of these changes on children and families. We also consider how the proposed changes are likely to create new challenges for parents who are attempting to organize their children's care and for pediatricians who are providing that care and assisting with care coordination.
Acute Outcomes and 1-Year Mortality of Intensive Care Unit–acquired Weakness. A Cohort Study and Propensity-matched Analysis
Authors: Greet Hermans, Helena Van Mechelen, Beatrix Clerckx, Tine Vanhullebusch, Dieter Mesotten, Alexander Wilmer, Michael P. Casaer, Philippe Meersseman, Yves Debaveye, Sophie Van Cromphaut, Pieter J. Wouters, Rik Gosselink, Greet Van den Berghe
Journal: American Journal of Respiratory and Critical Care Medicine (2014)

Intensive care unit (ICU)-acquired weakness is a frequent complication of critical illness. It is unclear whether it is a marker or mediator of poor outcomes.To determine acute outcomes, 1-year mortality, and costs of ICU-acquired weakness among long-stay (≥8 d) ICU patients and to assess the impact of recovery of weakness at ICU discharge.Data were prospectively collected during a randomized controlled trial. Impact of weakness on outcomes and costs was analyzed with a one-to-one propensity-score-matching for baseline characteristics, illness severity, and risk factor exposure before assessment. Among weak patients, impact of persistent weakness at ICU discharge on risk of death after 1 year was examined with multivariable Cox proportional hazards analysis.A total of 78.6% were admitted to the surgical ICU; 227 of 415 (55%) long-stay assessable ICU patients were weak; 122 weak patients were matched to 122 not-weak patients. As compared with matched not-weak patients, weak patients had a lower likelihood for live weaning from mechanical ventilation (hazard ratio [HR], 0.709 [0.549-0.888]; P = 0.009), live ICU (HR, 0.698 [0.553-0.861]; P = 0.008) and hospital discharge (HR, 0.680 [0.514-0.871]; P = 0.007). In-hospital costs per patient (+30.5%, +5,443 Euro per patient; P = 0.04) and 1-year mortality (30.6% vs. 17.2%; P = 0.015) were also higher. The 105 of 227 (46%) weak patients not matchable to not-weak patients had even worse prognosis and higher costs. The 1-year risk of death was further increased if weakness persisted and was more severe as compared with recovery of weakness at ICU discharge (P < 0.001).After careful matching the data suggest that ICU-acquired weakness worsens acute morbidity and increases healthcare-related costs and 1-year mortality. Persistence and severity of weakness at ICU discharge further increased 1-year mortality. Clinical trial registered with www.clinicaltrials.gov (NCT 00512122).