tbuckley/cabot-search huggingface dataset:
Prevalence and prediction of silent ischaemia in diabetes mellitus: a population-based study
Authors: O May
Journal: Cardiovascular Research (1997)

Objectives: The aim of the study was to estimate the prevalence of silent ischaemia in diabetic subjects in the population, to compare the prevalence of silent ischaemia in diabetics and non-diabetics and to attempt to predict the presence of silent ischaemia in diabetic subjects. Methods: A random sample of 120 users of insulin and 120 users of oral hypoglycaemic agents aged 40–75 years living in the Danish municipality of Horsens were asked to participate in the study. Corresponding to the youngest half of the sample two non-diabetic controls were randomly selected from the Central Population Register. ST-depression of horizontal or descending character of at least 0.1 mV measured 80 ms after the J-point on either exercise ECG or Holter ECG was considered indicative of myocardial ischaemia. Angina pectoris was considered present if the Rose questionnaire was positive, or chest pain was registered simultaneously with ECG evidence of ischaemia. Individuals with ischaemia, but without angina pectoris, were defined as persons with silent ischaemia. Results: Seventy-four percent of the invited group were included. The observed prevalence of silent ischaemia in diabetics was 13.5% (95%CI=8.5–19.8%). No association was found between silent ischaemia and gender (P=0.83) or diabetes type (P=0.67). In the group of diabetics who had controls, the prevalence was 11.4%, and among the controls the prevalence was 6.4% (OR=1.87, one-sided P=0.079). Systolic blood pressure was highly predictive of silent ischaemia in the diabetic subjects (P=0.005). No predictive value could be shown for other variables. Conclusion: This is the first population-based study of silent ischaemia in diabetes. The prevalence of silent ischaemia in diabetic subjects was 13.5%. The frequency of silent ischaemia did not differ significantly between diabetics and non-diabetics. Systolic blood pressure was predictive of silent ischaemia in diabetes.
Role of Albumin Treatment in Patients With Spontaneous Bacterial Peritonitis
Authors: Maria Poca, Mar Concepción, Meritxell Casas, Cristina Álvarez–Urturi, Jordi Gordillo, Virginia Hernández–Gea, Eva Román, Carlos Guarner–Argente, Ignasi Gich, German Soriano, Carlos Guarner
Journal: Clinical Gastroenterology and Hepatology (2011)
PTU-148 Healthcare Costs And Quality Of Life Associated With Acute Upper Gastrointestinal Bleeding In The Uk
Authors: E Stokes, H Campbell, D Bargo, M Murphy, R Logan, V Jairath
Journal: Gut (2014)

<h3>Introduction</h3> Acute upper gastrointestinal bleeding (AUGIB) accounts for over 70,000 hospital admissions in the UK annually. Its incidence is likely to rise due to an ageing population and increasing burden of liver disease. Data on the healthcare costs and health-related quality of life (HRQoL) associated with this condition are sparse. <h3>Methods</h3> The TRIGGER trial is a cluster randomised feasibility trial evaluating restrictive versus liberal red cell transfusion for patients with AUGIB. The study collected data on resource use, costs and outcomes during hospitalisation and up to day 28 to explore the feasibility of gathering inputs required for a cost-effectiveness analysis. Resource use data were collected during the inpatient episode on the use of laboratory tests, medications, blood components, endoscopy and endoscopic therapy, clinical events including ischaemic/thromboembolic events and length of hospital stay (LOS) by ward type. Data were also collected on primary and secondary care resource use, as well as informal care/days off work, post-discharge to day 28. Resource use for each patient was multiplied by national unit costs to generate an estimate of the costs of AUGIB to 28 days. HRQoL was measured on a scale anchored at 0 (death) and 1 (full health), using the EuroQol EQ-5D-3L questionnaire at day 28. <h3>Results</h3> 936 patients were enrolled into TRIGGER between August 2012 and March 2013 in 6 UK hospitals. Preliminary analyses show that the mean (standard error (SE)) cost of the inpatient episode was £1,914 (£78) per patient. LOS was a key cost driver; mean LOS was 5.4 days with an associated cost of £1431. Additional cost drivers included: (1) red cell transfusion, with a mean of 1.6 units transfused per patient at a cost of £197; (2) endoscopy, with mean of 0.8 endoscopies per patient at a cost of £169. Mean (SE) costs from hospital discharge to 28 days were £293 (£22) per patient. The main cost driver post discharge was readmission to hospital; 12% of patients were readmitted within 28 days for a mean of 4.8 days. The mean cost associated with readmission across all patients was £127. HRQoL was on average (SE) 0.68 (0.01) at 28 days. <h3>Conclusion</h3> The mean cost up to 28 days for patients presenting with AUGIB is £2,207. At 28 days, the mean HRQoL in patients who have experienced an AUGIB is well below the average population level of 0.86. This is the first study to provide detailed estimates of the costs and HRQoL associated with AUGIB in the UK. These data can be used by healthcare providers and researchers to inform the design of subsequent cost-effectiveness analyses of interventions for AUGIB. <h3>Disclosure of Interest</h3> None Declared.
Serum and Urinary Markers of Bone Remodeling: Assessment of Bone Turnover
Authors: SOL EPSTEIN
Journal: Endocrine Reviews (1988)

It appears that at present, serum BGP is the one bone protein that has the most promise for assisting in the diagnosis and management of high turnover metabolic bone disease states. If further studies confirm its usefulness in osteoporosis as a predictor of rapid bone loss without the need for bone biopsy, this serum marker will then not only allow early detection but also an appropriate choice of therapy in osteoporosis, i.e. the use of specific inhibitors of high turnover states such as estrogen, calcitonin, or bisphosphonates. In addition, it may also permit more accurate follow-up of patients suffering from diseases such as primary hyperparathyroidism after surgery. In low turnover osteoporosis, it may also serve a useful function to observe whether the osteoblast can be stimulated to enhance bone formation with therapies such as fluoride, anabolic steroids, PTH, etc. As yet, additional measurements, such as bone histomorphometry and other bone mineral markers, are required for definitive diagnosis. Hopefully, the availability of specific well-characterized antibodies against BGP may define its role more accurately. Recently, several other new bone proteins have been identified but at present they have very limited clinical application. Future studies into the structure-function relationship of these bone proteins may identify those markers which will be most relevant to the diagnosis and treatment of metabolic bone disease.
Comparing the prognostic value of risk stratifying models for patients with lower‐risk myelodysplastic syndromes: Is one model better?
Authors: Amer M. Zeidan, Mikkael A. Sekeres, Xiao‐Feng Wang, Najla Al Ali, Guillermo Garcia‐Manero, David P. Steensma, Gail Roboz, John Barnard, Eric Padron, Amy DeZern, Jaroslaw P. Maciejewski, Alan F. List, Rami S. Komrokji
Journal: American Journal of Hematology (2015)

Some patients classified as having lower‐risk (LR)‐disease by the International Prognostic Scoring System (IPSS) fare more poorly than predicted. We examined the prognostic utility of IPSS, the MD Anderson LR‐Prognostic System (LR‐PSS), and the revised IPSS (IPSS‐R) in a large cohort of patients classified as having IPSS LR‐MDS in the MDS Clinical Research Consortium database. Actual overall survival (OS) was assessed in patients with IPSS LR‐MDS (i.e. low and intermediate‐1) using Kaplan–Meier methods. Harrell's c index (HCI) and Akaike information criteria (AIC) were used to compare the models. Median OS of 1,140 eligible patients was 47 months (95% CI, 44–52). Median follow‐up was 62 months. HCI values indicating the discriminatory power of the models (higher is better) were better for LR‐PSS (0.74, 95% CI, 0.70–0.78) than IPSS‐R (0.64, 95% CI, 0.60–0.67) and IPSS (0.64, 95% CI, 0.60–0.68). Similarly, AIC values indicating the goodness of the fit were better for LR‐PSS than IPSS‐R and IPSS (8,110, 8,147, and 8,150, respectively, lower is better). LR‐PSS assigned 25.1% and 37.4% of patients with IPSS LR‐MDS into LR‐PSS Category 3 and IPSS‐R Categories ≥Intermediate, respectively. Of 291 patients (25.5%) who survived ≤24 months from diagnosis, only 37.1% and 45% were classified as LR‐PSS category 3 and IPSS‐R categories ≥Intermediate, respectively ( P = 0.06). While both LR‐PSS and IPSS‐R distinguish groups with varied survival outcome among patients with IPSS LR‐MDS, both tools fail to identify a significant subset with poor OS. Future studies should assess whether patients identified as at increased risk will benefit from earlier interventions with disease‐modifying therapies. Am. J. Hematol. 90:1036–1040, 2015. © 2015 Wiley Periodicals, Inc.
Antigen recognition by MHC-incompatible cells of a human mismatched chimera.
Authors: M G Roncarolo, H Yssel, J L Touraine, R Bacchetta, L Gebuhrer, J E De Vries, H Spits
Journal: The Journal of Experimental Medicine (1988)

Tetanus toxin (TT)-specific T cell clones of donor origin were obtained from a patient with severe combined immunodeficiency (SCID) successfully reconstituted by transplantation of allogeneic fetal liver and thymus cells from two different donors performed 10 yr ago. A series of these clones recognized TT in the context of "allo" class II HLA determinants expressed by recipient APC. The restriction element of two T cell clones with the HLA phenotype of the first donor (HLA-DR1,8) and one T cell clone with the HLA phenotype of the second transplant (HLA-DR3,9) was HLA-DR4 of the recipient, whereas other T cell clones derived from the second transplant recognized TT in the context of HLA-DR5 of the recipient's APC. These latter T cell clones were not able to proliferate in response to TT when autologous APC were used. These data demonstrate that recipient and donor cells having different HLA phenotypes could cooperate across the allogeneic barrier and that MHC restriction of antigen (Ag) recognition is independent from the MHC genotype of the T cells but is influenced by the environment in which the T cells mature. We also isolated T cell clones that were able to recognize processed TT presented by all allogeneic EBV cell lines tested, indicating that the Ag specificity of these clones was not restricted by a particular class II MHC molecule. The Ag-specific proliferative response of one of these clones could be blocked by anti-class II MHC mAbs. These results demonstrate that in addition to Ag recognition in the context of specific class II MHC Ags, other types of Ag-specific responses may occur in this human chimera. It is not clear whether this "allo" plus Ag recognition is the result of education of transplanted fetal cells in the host thymus. Taking into consideration our previous findings indicating that alloreactive T cell clones specific for the recipient cells could be isolated in vitro from the PBL of the same patient, our data suggest that the mechanism for deletion of self-reactive clones and the generation of MHC-restricted responses are different.
Vascular cell adhesion molecule-1 (VCAM-1) gene transcription and expression are regulated through an antioxidant-sensitive mechanism in human vascular endothelial cells.
Authors: N Marui, M K Offermann, R Swerlick, C Kunsch, C A Rosen, M Ahmad, R W Alexander, R M Medford
Journal: Journal of Clinical Investigation (1993)

Oxidative stress and expression of the vascular cell adhesion molecule-1 (VCAM-1) on vascular endothelial cells are early features in the pathogenesis of atherosclerosis and other inflammatory diseases. Regulation of VCAM-1 gene expression may be coupled to oxidative stress through specific reduction-oxidation (redox) sensitive transcriptional or posttranscriptional regulatory factors. In cultured human umbilical vein endothelial (HUVE) cells, the cytokine interleukin 1 beta (IL-1 beta) activated VCAM-1 gene expression through a mechanism that was repressed approximately 90% by the antioxidants pyrrolidine dithiocarbamate (PDTC) and N-acetylcysteine (NAC). Furthermore, PDTC selectively inhibited the induction of VCAM-1, but not intercellular adhesion molecule-1 (ICAM-1), mRNA and protein accumulation by the cytokine tumor necrosis factor-alpha (TNF alpha) as well as the noncytokines bacterial endotoxin lipopolysaccharide (LPS) and double-stranded RNA, poly(I:C) (PIC). PDTC also markedly attenuated TNF alpha induction of VCAM-1-mediated cellular adhesion. In a distinct pattern, PDTC partially inhibited E-selectin gene expression in response to TNF alpha but not to LPS, IL-1 beta, or PIC. TNF alpha and LPS-mediated transcriptional activation of the human VCAM-1 promoter through NF-kappa B-like DNA enhancer elements and associated NF-kappa B-like DNA binding proteins was inhibited by PDTC. These studies suggest a molecular linkage between an antioxidant sensitive transcriptional regulatory mechanism and VCAM-1 gene expression that expands on the notion of oxidative stress as an important regulatory signal in the pathogenesis of atherosclerosis.
Iron Supplement in Cancer Patients Receiving Erythropoietin
Authors: Paolo Pedrazzoli, Cinzia Tullio, Giulio Cerea, Salvatore Siena
Journal: Journal of Clinical Oncology (2004)

Auerbach et al 1 report on a randomized trial of iron supplement in cancer patients with chemotherapy-related anemia receiving recombinant human erythropoietin (rHuEPO).This study is important, because in previous clinical trials of rHuEPO, iron usage has never been energetically pursued in cancer patients and its use has been generally left to the discretion of the individual investigator.We would like to make the following remarks about the Auerbach et al trial for better interpretation of results.(1) Criteria for defining absolute or functional iron deficiency adopted by the authors should be detailed, as there is not concordance in the literature about this point 2 ; (2) the fraction of patients with absolute iron deficiency within the four study groups should be specified.Because of absence of iron stores, in this subset of patients, it is clinically cautious to postpone treatment with erythropoietic agents until iron stores are replenished or to treat iron deficiency aggressively along with rHuEPO therapy.In the same circumstances, administration of rHuEPO alone would be pathophysiologic nonsense. 3hen functional iron deficiency is present in patients receiving rHuEPO, iron repletion is already recommended based on indirect evidence and biologic inferences as literally stated in the American Society of Clinical Oncology/American Society of Hematology guidelines. 4The study by Auerbach et al 1 addresses this issue in a controlled trial for the first time and confirms that iron supplement should be given intravenously rather then orally, as the latter is shown largely ineffective in cancer patients as it also occurs in the setting of anemia in other chronic diseases. 5 major point that remains to be elucidated in the field of rHuEPO therapy for anemia of cancer is whether iron supplement is capable of increasing the fraction of patients without iron deficiency responding to erythropoietic agents.Owing to the increased erythropoietic activity stimulated by rHuEPO, adequate delivery of iron to the bone marrow from the beginning of rHuEPO therapy may well optimize response in these patients as well (ie, by avoiding the development of iron deficiency, whose occurrence during rHuEPO therapy represents a major limitation to its efficacy). 2This important point should be addressed in future prospective trials.
Evaluation of work-related psychosocial factors and regional musculoskeletal pain: results from a EULAR Task Force
Authors: G J Macfarlane, N Pallewatte, P Paudyal, F M Blyth, D Coggon, G Crombez, S Linton, P Leino-Arjas, A J Silman, R J Smeets, D van der Windt
Journal: Annals of the Rheumatic Diseases (2008)

<h3>Objectives:</h3> To establish whether review articles provide consistent conclusions on associations between workplace psychosocial factors and musculoskeletal pain and, if differences exist, to explore whether this is related to the methods used. <h3>Methods:</h3> Reviews, reported up to February 2007, that included consideration of workplace psychosocial factors and upper limb, back or knee pain were identified through searches of multiple databases. The specific work-related psychosocial factors considered were job demands, support, job autonomy and job satisfaction. The conclusions of each review on one or more of the psychosocial/musculoskeletal pain associations were extracted. <h3>Results:</h3> 15 review articles were identified that considered one or more of the regional pain syndromes included in the study. For back pain, the most consistent conclusions (four reviews positive out of six) were with high job demands and low job satisfaction. The studies of upper limb pain were exclusively related to shoulder and/or neck pain, and the most consistent positive conclusions were with high and low job demands (four reviews positive out of six and two reviews positive out of three, respectively). For knee pain, only a single review was identified. For individual reviews of back and upper limb pain, there were marked differences in the number of associations concluded to be positive between reviews. <h3>Conclusions:</h3> The reasons for reviews coming to different conclusions included that they were often evaluating different bodies of evidence (according to their search criteria, the year when the review was conducted, the role that quality assessment played in whether studies contributed to evidence, and the combination of risk factors addressed in individual studies), but more important was whether the review specified explicit criteria for making conclusions on strength of evidence. These conclusions emphasise the importance of developing standardised methods for conducting such evaluations of existing evidence and the importance of new longitudinal studies for clarifying the temporal relationship between psychosocial factors and musculoskeletal pain in the workplace.
Sodium-hydrogen exchange inhibitors improve postischaemic recovery of function in the perfused rabbit heart
Authors: M. Lee Myers, S. Mathur, G.-H. Li, M. Karmazyn
Journal: Cardiovascular Research (1995)

Objective: The aim was to examine the effects of the Na+/H+ exchange inhibitors amiloride and methylisobutyl amiloride (MIA) in buffer perfused rabbit hearts subjected to one hour of normothermic ischaemia (37 °C) followed by reperfusion. Methods: Experiments were carried out in five groups of Langendorff perfused rabbit hearts: (1) control, (2) amiloride, and (3) MIA (agents in both the preischaemic and reperfusion perfusate), (4) amiloride-R and (5) MIA-R (agents added at reperfusion only). Functional evaluation included serial measurement of resting tension, force, rates of ventricular force development and relaxation, and coronary perfusion pressure. Samples of coronary effluent were obtained for creatine kinase assay and hearts were freeze clamped for metabolite assays. Results: Reperfusion resulted in a marked increase in resting tension in group (1) which was statistically significant compared to groups (2) and (3). Groups (2) and (3) also showed significantly improved recovery of ventricular force, rate of force development, and rate of ventricular relaxation. Addition of either agent only during reperfusion failed to produce a significant beneficial effect. There were no significant differences among the groups with respect to postreperfusion creatine kinase release or end reperfusion metabolite levels. Conclusion: This study shows for the first time that both of the Na+/H+ exchange inhibitors amiloride and MIA produce improved recovery of ventricular function in rabbit hearts subjected to ischaemia and reperfusion, although the beneficial effect was not obtained with drug administration at the time of reperfusion only.
Treatment of erythroplasia of Queyrat with liquid nitrogen cryosurgery
Authors: T.S. SONNEX, I.G. RALFS, MARIA PLAZA DE LANZA, R.P.R. DAWBER
Journal: British Journal of Dermatology (1982)

SUMMARY Erythroplasia of Queyrat is now generally considered to be Bowen's disease of the glans penis. The literature is reviewed and the need for a treatment that is destructive to abnormal tissue yet cosmetically acceptable is stressed. Cryosurgery appears to be a very appropriate form of treatment for this condition – its effectiveness was demonstrated in two cases.
Mitral valve prolapse and joint hypermobility: evidence for a systemic connective tissue abnormality?
Authors: D Pitcher, R Grahame
Journal: Annals of the Rheumatic Diseases (1982)

Clinical evidence for an abnormally of extracardiac connective tissue was sought in 21 patients with idiopathic mitral valve prolapse and was compared to that in 21 matched controls. The incidence of rheumatic and orthopaedic complaints and the prevalence of hypermobile joints, Marfanoid habitus, and skeletal deformity were compared in the 2 groups. Skin thickness and elasticity were measured, and the mean values in the 2 groups were compared. hypermobile joints were significantly commoner in patients with mitral valve prolapse. Easy bruising was reported significantly more commonly by patients with mitral prolapse; the incidence of other rheumatic complaints was similar in the 2 groups. There was no significant difference in skin thickness, skin elasticity, and the prevalence of either skeletal deformity or Marfanoid habitus between patients with mitral valve prolapse and controls. The results support previous evidence of an association between mitral valve prolapse and benign hypermobility of the joints, but emphasise that many patients with mitral valve prolapse have no clinically apparent connective tissue abnormality outside the heart. It remains uncertain whether the valve lesion in these patients represents a tissue-specific abnormality of mitral valve collagen or the only clinical expression of a minor systemic connective tissue abnormality.
The Effect of Glucose Variability on the Risk of Microvascular Complications in Type 1 Diabetes
Authors: Eric S. Kilpatrick, Alan S. Rigby, Stephen L. Atkin
Journal: Diabetes Care (2006)

It is not known whether glycemic instability may confer a risk of microvascular complications that is in addition to that predicted by the mean blood glucose (MBG) value alone. This study has analyzed data from the Diabetes Control and Complications Trial (DCCT) to assess the effect of glucose variability on the risk of retinopathy and nephropathy in patients with type 1 diabetes.Pre- and postprandial seven-point glucose profiles were collected quarterly during the DCCT in 1,441 individuals. The mean area under the curve glucose and the SD of glucose variability within 24 h and between visits were compared with the risk of retinopathy and nephropathy, having adjusted for age, sex, disease duration, treatment group, prevention cohort, and phase of treatment.Multivariate Cox regression showed that within-day and between-day variability in blood glucose around a patient's mean value has no influence on the development or progression of either retinopathy (P = 0.18 and P = 0.72, respectively) or nephropathy (P = 0.32 and P = 0.57). Neither preprandial (P = 0.18) nor postprandial (P = 0.31) glucose concentrations preferentially contribute to the probability of retinopathy.This study has shown that blood glucose variability does not appear to be an additional factor in the development of microvascular complications. Also, pre- and postprandial glucose values are equally predictive of the small-vessel complications of type 1 diabetes.