tbuckley/cabot-search huggingface dataset:
Medical aspects of terrorist bombings – a focus on DCS and DCR
Authors: Ventsislav M Mutafchiyski, Georgi I Popivanov, Kirien C Kjossev
Journal: Military Medical Research (2014)

Although terrorist bombings have tormented the world for a long time, currently they have reached unprecedented levels and become a continuous threat without borders, race or age. Almost all of them are caused by improvised explosive devices. The unpredictability of the terrorist bombings, leading to simultaneous generation of a large number of casualties and severe “multidimensional” blast trauma require a constant vigilance and preparedness of every hospital worldwide. Approximately 1-2.6% of all trauma patients and 7% of the combat casualties require a massive blood transfusion. Coagulopathy is presented in 65% of them with mortality exceeding 50%. Damage control resuscitation is a novel approach, developed in the military practice for treatment of this subgroup of trauma patients. The comparison with the conventional approach revealed mortality reduction with 40-74%, lower frequency of abdominal compartment syndrome (8% vs. 16%), sepsis (9% vs. 20%), multiorgan failure (16% vs. 37%) and a significant reduction of resuscitation volumes, both crystalloids and blood products. DCS and DCR are promising new approaches, contributing for the mortality reduction among the most severely wounded patients. Despite the lack of consensus about the optimal ratio of the blood products and the possible influence of the survival bias, we think that DCR carries survival benefit and recommend it in trauma patients with exsanguinating bleeding.
Two Distinct Mechanisms of Augmented Antitumor Activity by Modulation of Immunostimulatory/Inhibitory Signals
Authors: Jun Mitsui, Hiroyoshi Nishikawa, Daisuke Muraoka, Linan Wang, Takuro Noguchi, Eiichi Sato, Satoshi Kondo, James P. Allison, Shimon Sakaguchi, Lloyd J. Old, Takuma Kato, Hiroshi Shiku
Journal: Clinical Cancer Research (2010)

Blockade of CTL-associated antigen-4 (CTLA-4), an inhibitory immunomodulatory molecule on T cells, has been shown to enhance T-cell responses and induce tumor rejection, and a number of clinical trials with anti-CTLA-4 blocking monoclonal antibody (mAb) are under way. However, accumulating evidence indicates that anti-CTLA-4 mAb increases the number of CD4+CD25+Foxp3+ regulatory T cells (Treg) and that anti-CTLA4 mAb alone is often insufficient to reject established tumors in mice and humans. Thus, finding maneuvers to control Tregs and other immunosuppressive mechanisms remains a critical challenge.The potential to enhance antitumor immune responses by combining anti-CTLA-4 mAb with anti-glucocorticoid-induced tumor necrosis factor receptor family related gene (GITR) mAb, a costimulatory molecule that abrogates directly/indirectly Treg-mediated immune suppression or anti-CD25 mAb that depletes Tregs was analyzed with two tumor models, CT26 (a murine colon carcinoma cell line) and CMS5a (a murine fibrosarcoma cell line).Anti-CTLA-4/anti-GITR mAb combination treatment exhibited far stronger antitumor effects compared with either antibody alone. This strong antitumor effect was attributed to (a) increased numbers of CD8+ T cells infiltrating tumor sites in anti-CTLA-4 mAb-treated mice and (b) increased cytokine secretion and Treg resistance of tumor-specific CD8+ T cells with strongly upregulated CD25 expression in anti-GITR mAb-treated mice, indicating distinct quantitative/qualitative changes induced by modulating CTLA-4 and GITR signaling.This study shows that combined treatment with different immune modulators can augment antitumor immune responses and provides justification for exploring anti-CTLA-4/anti-GITR mAb combination treatment in the clinic.
Cu<sub>2–<i>x</i></sub>Se Nanocrystals with Localized Surface Plasmon Resonance as Sensitive Contrast Agents for In Vivo Photoacoustic Imaging: Demonstration of Sentinel Lymph Node Mapping
Authors: Xin Liu, Wing‐Cheung Law, Mansik Jeon, Xianliang Wang, Maixian Liu, Chulhong Kim, Paras N. Prasad, Mark T. Swihart
Journal: Advanced Healthcare Materials (2013)

The promise of a new nanomaterial, Cu2–xSe nanocrystals, as a contrast agent for photoacoustic imaging is demonstrated. The Cu2–xSe nanocrystals exhibit strong optical absorption at near infrared wavelengths that can efficiently penetrate tissue. In vivo photoacoustic tomography using this nanomaterial as the contrast agent provides clear three-dimensional resolution of a sentinel lymph node in a rat model. As a service to our authors and readers, this journal provides supporting information supplied by the authors. Such materials are peer reviewed and may be re-organized for online delivery, but are not copy-edited or typeset. Technical support issues arising from supporting information (other than missing files) should be addressed to the authors. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
Impact of Baseline Insulin Regimen on Glycemic Response to a Group Medical Clinic Intervention
Authors: Matthew J. Crowley, Stephanie D. Melnyk, Cynthia J. Coffman, Amy S. Jeffreys, David Edelman
Journal: Diabetes Care (2013)

OBJECTIVE Group medical clinics (GMC) combine medication management and self-management training, and may improve diabetes outcomes. It remains unclear which patients benefit most from GMC. This secondary analysis examined the impact of baseline insulin regimen on GMC response. RESEARCH DESIGN AND METHODS We analyzed a trial of 239 veterans with type 2 diabetes randomized to GMC or usual care (UC). We categorized baseline insulin regimen as the following: no insulin; basal insulin only; or complex insulin (basal–prandial or mixed regimens). Using linear mixed models adjusted for clustering within GMC, we evaluated the differential impact of GMC relative to UC on hemoglobin A1c (HbA1c) and self-efficacy among patients on different baseline insulin regimens. RESULTS From linear mixed models, the effect of GMC on HbA1c differed by baseline insulin regimen versus UC (P = 0.05); there was no differential effect on self-efficacy (P = 0.29). Among those using complex insulin regimens at baseline, GMC reduced HbA1c by study end compared with UC (−1.0%; 95% CI −1.8 to −0.2; P = 0.01). We found no such HbA1c difference between GMC and UC patients using no insulin (P = 0.65) or basal insulin only (P = 0.71). There were no clinically significant differences in hypoglycemia by baseline insulin regimen and intervention group. CONCLUSIONS We found that compared with UC, GMC lowered HbA1c specifically among patients using complex insulin regimens at study baseline, which may relate to this group’s demanding medication and self-management requirements. Implementing GMC among patients using complex insulin regimens may maximize this care delivery strategy’s potential.
Decompressive Craniectomy in Diffuse Traumatic Brain Injury
Authors: D. James Cooper, Jeffrey V. Rosenfeld, Lynnette Murray, Yaseen M. Arabi, Andrew R. Davies, Paul D'Urso, Thomas Kossmann, Jennie Ponsford, Ian Seppelt, Peter Reilly, Rory Wolfe
Journal: New England Journal of Medicine (2011)

It is unclear whether decompressive craniectomy improves the functional outcome in patients with severe traumatic brain injury and refractory raised intracranial pressure.From December 2002 through April 2010, we randomly assigned 155 adults with severe diffuse traumatic brain injury and intracranial hypertension that was refractory to first-tier therapies to undergo either bifrontotemporoparietal decompressive craniectomy or standard care. The original primary outcome was an unfavorable outcome (a composite of death, vegetative state, or severe disability), as evaluated on the Extended Glasgow Outcome Scale 6 months after the injury. The final primary outcome was the score on the Extended Glasgow Outcome Scale at 6 months.Patients in the craniectomy group, as compared with those in the standard-care group, had less time with intracranial pressures above the treatment threshold (P<0.001), fewer interventions for increased intracranial pressure (P<0.02 for all comparisons), and fewer days in the intensive care unit (ICU) (P<0.001). However, patients undergoing craniectomy had worse scores on the Extended Glasgow Outcome Scale than those receiving standard care (odds ratio for a worse score in the craniectomy group, 1.84; 95% confidence interval [CI], 1.05 to 3.24; P=0.03) and a greater risk of an unfavorable outcome (odds ratio, 2.21; 95% CI, 1.14 to 4.26; P=0.02). Rates of death at 6 months were similar in the craniectomy group (19%) and the standard-care group (18%).In adults with severe diffuse traumatic brain injury and refractory intracranial hypertension, early bifrontotemporoparietal decompressive craniectomy decreased intracranial pressure and the length of stay in the ICU but was associated with more unfavorable outcomes. (Funded by the National Health and Medical Research Council of Australia and others; DECRA Australian Clinical Trials Registry number, ACTRN012605000009617.).
Memory Th1 Cells Augment Tumor-Specific CTL following Transcutaneous Peptide Immunization
Authors: Akihiro Hosoi, Yayoi Takeda, Yoshihiro Furuichi, Makoto Kurachi, Kiminori Kimura, Ryuji Maekawa, Kiyoshi Takatsu, Kazuhiro Kakimi
Journal: Cancer Research (2008)

Abstract Targeting dendritic cells in vivo by transcutaneous peptide immunization (TCI) represents an efficient immunization strategy to induce tumor-specific CTL because it reflects the physiologic conditions occurring during pathogen infection. Here we show that including a Th1 peptide in TCI can activate preexisting memory Th1 (mTh1) responses and thereby enhance the CTL response. For this purpose, peptide-25, a major Th1 epitope of Ag85B from Mycobacterium tuberculosis, was selected. We adoptively transferred peptide-25–specific mTh1 cells and hgp100-specific naive CTL (pmel-1 TCR transgenic) into C57BL/6 mice. Subsequently, mice were transcutaneously immunized with CTL peptide (hgp100) and Th1 peptide (peptide-25). Five days after TCI, the frequency and function of pmel-1 cells was monitored by intracellular IFN-γ staining, ELISPOT, and in vivo cytotoxicity assays. TCI efficiently expanded hgp100-specific, IFN-γ–producing, strongly cytotoxic CD8+ T cells. Concurrent activation of mTh1 cells by peptide-25 induced a 1.5-fold increase in the number of hgp100-specific CTL with enhanced effector functions. Furthermore, TCI elicited not only prophylactic but also therapeutic antitumor responses that were augmented by peptide-25. These results show that TCI facilitates peptide-specific activation of CD4+ T cells, responsible for the augmenting effect of peptide-25 on the hgp100-specific CTL response. Because a significant proportion of the Japanese population has been vaccinated with Bacillus Calmette-Guerin, they are likely to possess Ag85B- or peptide-25–specific mTh1 cells. Therefore, concomitant activation of Ag85B- or peptide-25–specific mTh1 cells together with tumor-specific CTL by TCI might augment antitumor immune responses in a sizeable fraction of patients. [Cancer Res 2008;68(10):3941–9]
Evidence for Dysregulation of Dimethylarginine Dimethylaminohydrolase I in Chronic Hypoxia–Induced Pulmonary Hypertension
Authors: Lesley J. Millatt, Guy StJ. Whitley, Dechun Li, James M. Leiper, Helmy M. Siragy, Robert M. Carey, Roger A. Johns
Journal: Circulation (2003)

Background— Chronic hypoxia–induced pulmonary hypertension is associated with increased pulmonary expression of nitric oxide synthase (NOS) enzymes. Nevertheless, some reports have indicated decreased pulmonary production of NO in the disease. To address this paradox, we determined pulmonary concentrations of the endogenous NOS inhibitor asymmetric dimethylarginine (ADMA) in the hypoxia-induced pulmonary hypertension rat model. In addition, we determined whether dysregulation of the ADMA-metabolizing enzyme dimethylarginine dimethylaminohydrolase I (DDAH I) plays a role in this disease. Methods and Results— Adult male rats were exposed for 1 week to either normoxia or hypoxia (10% oxygen). Lung tissues were used for Western blot analysis of endothelial NOS and DDAH I expression, measurement of lung NO and ADMA content, and in vitro assay of DDAH enzyme activity. Western blot analysis revealed a 1.9-fold increase in endothelial NOS protein and a 37% decrease in DDAH I protein in the lungs of hypoxia-exposed rats. Both pulmonary DDAH enzyme activity and NO content were significantly decreased in the hypoxic group (by 37% and 22%, respectively), but pulmonary ADMA concentrations were increased by 2.3-fold compared with the normoxic group. Conclusions— These data demonstrate that the rat chronic hypoxia–induced pulmonary hypertension model is associated with increased pulmonary concentrations of the NOS inhibitor ADMA. Moreover, pulmonary hypertensive rats exhibit reduced pulmonary expression and activity of the ADMA-metabolizing enzyme DDAH I. The decreased DDAH I and increased ADMA concentrations may therefore contribute to pulmonary hypertension via the competitive inhibition of pulmonary NOS enzymes.
Side Effects of Glucocorticoid Treatment
Authors: Georgia A. Chrousos
Journal: JAMA (1993)

<h3>Objective.</h3> —To determine the incidence of side effects from short-term glucocorticoid therapy prescribed for treatment of optic neuritis in the Optic Neuritis Treatment Trial. <h3>Design.</h3> —Randomized, placebo-controlled, multicenter clinical trial. <h3>Setting.</h3> —Fifteen university- or hospital-based centers throughout the United States. <h3>Patients.</h3> —A total of 457 patients between the ages of 18 and 46 years with acute demyelinative optic neuritis were studied. <h3>Interventions.</h3> —(1) Intravenous methylprednisolone (250 mg every 6 hours) for 3 days while hospitalized followed by oral prednisone (1 mg/kg per day) for 11 days; (2) oral prednisone (1 mg/kg per day) for 14 days; and (3) oral placebo for 14 days. Each regimen was followed by a short taper. <h3>Results.</h3> —Only two patients experienced major side effects, psychotic depression in one and acute pancreatitis in the other. Both of these patients were from the intravenous methylprednisolone group and both of the side effects resolved without sequelae. Patients in both groups receiving active drugs more often reported sleep disturbances, mood change, stomach upset, and facial flushing and gained more weight during the treatment period than patients in the placebo group (<i>P</i>&lt;.001 for each comparison). <h3>Conclusions.</h3> —Although minor side effects are common, short-term glucocorticoid therapy in young, healthy adults is relatively safe. Because of the infrequency of serious side effects, outpatient administration of high-dose intravenous glucocorticoids may be feasible. (<i>JAMA</i>. 1993;269:2110-2112)
Clinical trials of homoeopathy.
Authors: J Kleijnen, P Knipschild, G ter Riet
Journal: BMJ (1991)

OBJECTIVE--To establish whether there is evidence of the efficacy of homoeopathy from controlled trials in humans. DESIGN--Criteria based meta-analysis. Assessment of the methodological quality of 107 controlled trials in 96 published reports found after an extensive search. Trials were scored using a list of predefined criteria of good methodology, and the outcome of the trials was interpreted in relation to their quality. SETTING--Controlled trials published world wide. MAIN OUTCOME MEASURES--Results of the trials with the best methodological quality. Trials of classical homoeopathy and several modern varieties were considered separately. RESULTS--In 14 trials some form of classical homoeopathy was tested and in 58 trials the same single homoeopathic treatment was given to patients with comparable conventional diagnosis. Combinations of several homoeopathic treatments were tested in 26 trials; isopathy was tested in nine trials. Most trials seemed to be of very low quality, but there were many exceptions. The results showed a positive trend regardless of the quality of the trial or the variety of homeopathy used. Overall, of the 105 trials with interpretable results, 81 trials indicated positive results whereas in 24 trials no positive effects of homoeopathy were found. The results of the review may be complicated by publication bias, especially in such a controversial subject as homoeopathy. CONCLUSIONS--At the moment the evidence of clinical trials is positive but not sufficient to draw definitive conclusions because most trials are of low methodological quality and because of the unknown role of publication bias. This indicates that there is a legitimate case for further evaluation of homoeopathy, but only by means of well performed trials.
Treatment of Intractable Ulcerating Enterocolitis of Infancy by Allogeneic Bone Marrow Transplantation
Authors: Nikhil Thapar, Keith J. Lindley, Fevronia Kiparissi, Mamoun A. Elawad, Michael Ashworth, Paul Veys, Hubert B. Gaspar, Susan M. Hill, Peter J. Milla, Neil Shah
Journal: Clinical Gastroenterology and Hepatology (2008)
Intracellular electrolyte depletion in patients with ileostomies.
Authors: L A Turnberg, A I Morris, P C Hawker, K J Herman, R A Shields, C E Horth
Journal: Gut (1978)

Fourteen apparently healthy patients with ileostomies were found to be depleted of total exchangeable sodium and potassium, but had normal serum electrolyte concentrations and normal extracellular fluid and total body water volumes. The low exchangeable sodium and potassiums were thus primarily due to depletion of the intracellular compartment. There was no evidence of renal or intestinal conservation of these ions and plasma aldosterone, renin activity, and prolactin concentrations were normal in most and only moderately raised in a few. This apparent lack of any hormonal compensatory change to the electrolyte depletion may be due to the normality of the extracellular fluid volume and electrolyte concentrations. These patients seem to have adapted to a stable but depleted intracellular sodium and potassium state.
Management of rice stem borers (Lepidoptera: Pyralidae) through host plant resistance in early, medium and late plantings of rice (Oryza sativa L.)
Authors: Muhammad Sarwar
Journal: Journal of Clinical Oncology (2012)

This study was conducted to determine the effects of host plant resistance in early, medium and late sown varieties of rice [2 non aromatic IR8 (P) and Sharshar, and 2 aromatic Basmati-370 (P) and Mehak] due to the incidence of rice stem borers. Treatments comprised the crop sown on 3 different dates at the fortnightly intervals starting from the last week of June till the end of July to note the rate of stem borer’s infestation. The data on the incidences of insect pests and yield performances of ricevarieties were studied. Rice yellow stem borer Scirpophaga incertulas (Walker)  (Lepidoptera: Pyralidae), was the most important insect pest of rice, attacking all stages of the crop causing substantial losses in early, medium and late-sown crops, and degree of stem borer infestation depended upon the planting time. The pest incidence was the least on early sown crop as compared to medium and late sown crops. Similarly, the highest yield was obtained in early sown crop, and the crop sown after this date showed drastic reductions in yield. Among different varieties tested, Sharshar showed best results in holding least pest infestation and increased grain yield approached by, IR8 (P), Mehakand Basmati-370 (P). Hence, use of tolerant rice varieties and their early sowing under agro climatic conditions of this region is recommended to protect the crop from borer’s invasion.

	 

	 Key words: Rice, yellow stem borer, resistance, planting time, Scirpophaga, Oryza sativa.
Effective time of the forced expiratory spirogram in health and airways obstruction.
Authors: J Jordanoglou, E Koursouba, C Lalenis, T Gotsis, J Kontos, C Gardikas
Journal: Thorax (1979)

We have calculated the effective time (t eff) of the forced expiratory spirogram in healthy non-smokers, in patients with simple chronic bronchitis, and in patients with chronic obstructive lung disease. Effective time was obtained by dividing the area underneath the forced expiratory spirogram by the forced vital capacity (FVC) and is equal to the time constant of lung emptying if the FVC-time curve is a single exponential. In 75 healthy non-smoking adults, t eff showed a linear increase with age but no difference between the sexes. In 37 patients with low forced expiratory volume in one second (FEV1)/FVC ratios, t eff, as expected, was increased. In 19 subjects with simple chronic bronchitis and normal FEV1/FVC ratios, t eff was longer than or at the upper limit of 2 SE above the mean for healthy subjects of the same age. A comparison of t eff with FEV1/FVC suggested that in most normal subjects and patients the forced expiratory spirogram was a multiple exponential and that t eff was a more sensitive index for the evaluation of airway obstruction than the FEV1/FVC ratio.
Gastrointestinal Blood Flow in the Dog
Authors: JOHN P. DELANEY, JAMES CUSTER
Journal: Circulation Research (1965)

That the radiorubidium distribution method provides good estimates of blood flow to the gastrointestinal organs was demonstrated by comparing the arterial concentration course of the isotope with the simultaneous venous concentration for the individual organs. Blood flow to stomach, intestine and colon are accurately assessed by this method. Estimates for pancreas, gall bladder, esophagus and duodenum are probably correct. Average perfusion rates in the pentobarbital anesthetized dog are, in cc/min.g of tissue: --esophagus, 0.21; stomach, 0.51; duodenum, 0.70; small intestine, 0.72; colon, 0.82; pancreas, 0.60; and gall bladder, 0.39.
From Quality of Publication to Quality of Care: Translating Trials to Practice
Authors: Janet E. Dancey
Journal: JNCI Journal of the National Cancer Institute (2010)

Results from randomized controlled trials (RCTs) can have an immediate impact on patient care. Accurate and complete reporting is essential to determine whether trial design, conduct, and analyses are scientifically creditable. Consolidated Standards of Reporting Trials (CONSORT) require explicit reporting of specific components of trial methodology necessary to allow readers to accurately assess trial validity (1–3). Trial information should also be informative, allowing readers to determine whether the results are able to be generalized to non-trial patients and whether the risk to benefit ratio of the intervention is medically acceptable. Although adherence to CONSORT guidelines allows reviewers, journal editors, and readers to judge the quality of trial methodology and validity of results, these guidelines do not necessarily ensure the reporting of sufficient information for quality application of treatment within the broad clinical community following trial publication. After reading the trial publication, the oncology care provider should be able to judge the credibility of the results and the risks and benefits and decide on whether to begin recommending the new treatment to patients within his or her practice. The need for clinicians to understand all trial details is especially important for trials of oncology therapeutics, which are often toxic and complex. Cancer treatment regimens may require combinations of drugs, radiation, and surgery applied in certain sequences and time frames. Treatment modifications, delays, and interruptions and supportive care measures that were specified within the protocol assure a degree of uniform application within the trial that might not be applied in broad clinical practice. Increased toxicities and reduced efficacy of new agents following trial publication may be partially explained by differences in patient populations, difference in treatment administration, and clinician experience (4). In this issue of the Journal, Duff et al. (5) describe an additional possible explanation for the lower effectiveness of treatments in clinical use relative to trial reports: a lack of description of the experimental treatment within the trial publication that might limit the replication of the protocol-specified trial intervention in clinical