tbuckley/cabot-search huggingface dataset:
Open-label trial of oral nalmefene therapy for the pruritus of cholestasis
Authors: Nora V. Bergasa, Joseph M. Schmitt, Thomas L. Talbot, David W. Alling, Mark G. Swain, Maria L. Turner, Janice B. Jenkins, Anthony E. Jones
Journal: Hepatology (1998)

The aims of this study were to determine whether long-term oral administration of the opiate antagonist nalmefene is associated with any beneficial effects in patients with pruritus secondary to cholestatic liver disease and to assess the safety of long-term administration of this drug to these patients. Fourteen patients with unrelieved chronic pruritus of cholestasis were studied. Scratching activity, independent of limb movements, was recorded continuously for 24-hour periods before and during treatment with an initial ameliorating dose of nalmefene. Simultaneously, during these periods, visual analogue scores (VASs) of pruritus were recorded every 4 hours while patients were awake. The dose of nalmefene, which initially was 2 mg orally twice daily, was increased during the study, usually until a satisfactory clinical response was achieved. Five patients experienced a transient opioid withdrawal-like reaction that did not preclude continuing with nalmefene therapy. Serum biochemical indices of cholestasis did not change appreciably during treatment. Thirteen patients reported amelioration of the perception of pruritus on nalmefene. In 5 patients, exacerbations of pruritus occurred approximately 4 weeks after an initial ameliorating dose had been reached; these exacerbations were managed by increasing the dose. Baseline mean values for VAS and scratching activity were higher than corresponding means during nalmefene therapy in 13 ( P =.002) and 12 ( P = .013) patients, respectively. Possible tolerance to nalmefene occurred in 3 patients. Three patients experienced marked exacerbation of pruritus after nalmefene therapy was suddenly discontinued. Blood levels of nalmefene were consistent with normal pharmacokinetics of the drug. These results suggest that nalmefene may have a favorable risk-to-benefit ratio when it is administered orally long-term to patients with the pruritus of cholestasis.
Breastfeeding Plus Infant Zidovudine Prophylaxis for 6 Months vs Formula Feeding Plus Infant Zidovudine for 1 Month to Reduce Mother-to-Child HIV Transmission in Botswana
Authors: Ibou Thior, Shahin Lockman, Laura M Smeaton, Roger L Shapiro, Carolyn Wester, S Jody Heymann, Peter B Gilbert, Lisa Stevens, Trevor Peter, Soyeon Kim, Erik van Widenfelt, Claire Moffat, Patrick Ndase, Peter Arimi, Poloko Kebaabetswe, Patson Mazonde, Joseph Makhema, Kenneth McIntosh, Vladimir Novitsky, Tun-Hou Lee, Richard Marlink, Stephen Lagakos, Max Essex
Journal: JAMA (2006)

Postnatal transmission of human immunodeficiency virus-1 (HIV) via breastfeeding reverses gains achieved by perinatal antiretroviral interventions.To compare the efficacy and safety of 2 infant feeding strategies for the prevention of postnatal mother-to-child HIV transmission.A 2 x 2 factorial randomized clinical trial with peripartum (single-dose nevirapine vs placebo) and postpartum infant feeding (formula vs breastfeeding with infant zidovudine prophylaxis) interventions. In Botswana between March 27, 2001, and October 29, 2003, 1200 HIV-positive pregnant women were randomized from 4 district hospitals. Infants were evaluated at birth, monthly until age 7 months, at age 9 months, then every third month through age 18 months.All of the mothers received zidovudine 300 mg orally twice daily from 34 weeks' gestation and during labor. Mothers and infants were randomized to receive single-dose nevirapine or placebo. Infants were randomized to 6 months of breastfeeding plus prophylactic infant zidovudine (breastfed plus zidovudine), or formula feeding plus 1 month of infant zidovudine (formula fed).Primary efficacy (HIV infection by age 7 months and HIV-free survival by age 18 months) and safety (occurrence of infant adverse events by 7 months of age) end points were evaluated in 1179 infants.The 7-month HIV infection rates were 5.6% (32 infants in the formula-fed group) vs 9.0% (51 infants in the breastfed plus zidovudine group) (P = .04; 95% confidence interval for difference, -6.4% to -0.4%). Cumulative mortality or HIV infection rates at 18 months were 80 infants (13.9%, formula fed) vs 86 infants (15.1% breastfed plus zidovudine) (P = .60; 95% confidence interval for difference, -5.3% to 2.9%). Cumulative infant mortality at 7 months was significantly higher for the formula-fed group than for the breastfed plus zidovudine group (9.3% vs 4.9%; P = .003), but this difference diminished beyond month 7 such that the time-to-mortality distributions through age 18 months were not significantly different (P = .21).Breastfeeding with zidovudine prophylaxis was not as effective as formula feeding in preventing postnatal HIV transmission, but was associated with a lower mortality rate at 7 months. Both strategies had comparable HIV-free survival at 18 months. These results demonstrate the risk of formula feeding to infants in sub-Saharan Africa, and the need for studies of alternative strategies.clinicaltrials.gov Identifier: NCT00197587.
Interstitial pressure and lung oedema in chronic hypoxia
Authors: I. Rivolta, V. Lucchini, M. Rocchetti, F. Kolar, F. Palazzo, A. Zaza, G. Miserocchi
Journal: European Respiratory Journal (2010)

We evaluated how the increase in lung interstitial pressure correlates with the pulmonary vascular response to chronic hypoxia. In control and hypoxic (30 days; 10% O 2 ) Wistar male rats, we measured: pulmonary interstitial pressure ( P ip ), cardiac and haemodynamic parameters by echocardiography, and performed lung morphometry on tissue specimens fixed in situ . In control animals, mean± sd P ip , air/tissue volume ratio and capillary vascularity index in the air–blood barrier were -12±2.03 cmH 2 O, 3.9 and 0.43, respectively. After hypoxia exposure, the corresponding values of these indices in apparently normal lung regions were 2.6±1.7 cmH 2 O, 3.6, and 0.5, respectively. In oedematous regions, the corresponding values were 12±4 cmH 2 O, 0.4 and 0.3, respectively. Furthermore, in normal regions, the density of pre-capillary vessels (diameter ∼50–200 μm) increased and their thickness/internal diameter ratio decreased, while opposite results were found in oedematous regions. Pulmonary artery pressure increased in chronic hypoxia relative to the control (39.8±5.9 versus 26.2±2.2 mmHg). Heterogeneity in local lung vascular response contributes to developing pulmonary hypertension in chronic hypoxia. In oedematous regions, the decrease in capillary vascularity correlated with the remarkable increase in interstitial pressure and morphometry of the pre-capillary vessels suggested an increase in vascular resistance; the opposite was true in apparently normal regions.
MicroRNA-29c mediates initiation of gastric carcinogenesis by directly targeting ITGB1
Authors: Tae-Su Han, Keun Hur, Guorong Xu, Boram Choi, Yoshinaga Okugawa, Yuji Toiyama, Hiroko Oshima, Masanobu Oshima, Hyuk-Joon Lee, V Narry Kim, Aaron N Chang, Ajay Goel, Han-Kwang Yang
Journal: Gut (2014)

We report an unusual case in which physiologic neck rotation impeded perfusion through the internal carotid artery. The patient had a history of prior radical neck surgery and radiation for malignancy. He presented withbow hunter's-like symptoms with transient loss of consciousness and right-sided weakness with left lateral neck rotation. A self-expanding peripheral stent was successfully used to treat the patient by preventing rotatory carotid compression. In select patients with prior neck surgery and radiation, carotid injections should be part of a dynamic cerebral angiogram if the vertebral arteries are unremarkable.
The Treatment of Rheumatism in General Practice
Authors: W. Yeoman
Journal: Annals of the Rheumatic Diseases (1948)

REVIEWSforced movement is recommended, but it is not suffi- ciently stressed that if this is done in the active stage of the disease there may be a very painful reaction.The large subject of rheumatoid arthritis is dealt with in a few pages.Gold salt therapy is suggested and the toxic manifestations are mentioned, but no advice is given as to their treatment.Osteo-arthritis is dealt with in an even more summary manner.It is difficult to understand why the author of this well-produced book has included the term rheumatism in his title, for he dismisses most types of the rheumatic diseases briefly at the beginning and end of the book.OSWALD SAVAGE.
Association of population and primary healthcare factors with hospital admission rates for chronic obstructive pulmonary disease in England: national cross-sectional study
Authors: A. Calderon-Larranaga, L. Carney, M. Soljak, A. Bottle, M. Partridge, D. Bell, G. Abi-Aad, P. Aylin, A. Majeed
Journal: Thorax (2010)

<h3>Background</h3> Hospital admission rates for chronic obstructive pulmonary disease (COPD) are known to be strongly associated with population factors. Primary care services may also affect admission rates, but there is little direct supporting evidence. <h3>Objectives</h3> To determine associations between population characteristics, diagnosed and undiagnosed COPD prevalence, primary healthcare factors, and COPD admission rates primary care trust (PCT) and general practice levels in England. <h3>Design, setting, and participants</h3> National cross-sectional study (53,676,051 patients in 8,064 practices in 152 English PCTs), combining data on hospital admissions, populations, primary healthcare staffing, clinical practice quality and access, and prevalence. <h3>Main outcome measures</h3> Directly and indirectly standardised hospital admission rates for COPD, for PCT and practice populations. <h3>Results</h3> Mean annual COPD admission rates per 100 000 population varied from 124.7 to 646.5 for PCTs and 0.0 to 2175.2 for practices. Admissions were strongly associated with population deprivation at both levels. In a practice-level multivariate Poisson regression, registered and undiagnosed COPD prevalence, smoking prevalence and deprivation were risk factors for admission (p&lt;0.001), while healthcare factors- influenza immunisation, patient-reported access to consultations within two days, and primary care staffing, were protective (p&lt;0.05). <h3>Conclusion</h3> Associations of COPD admission rates with deprivation, primary healthcare access and supply highlight the need for adequate services in deprived areas. An association between admission rates and undiagnosed COPD prevalence suggests that case-finding strategies should be evaluated. Of the COPD clinical quality indicators, only influenza immunisation was associated with reduced admission rates. Patients9 experience of access to primary care may also be clinically important.
Prevalence of Chronic Obstructive Pulmonary Disease Among Those With Serious Mental Illness
Authors: Seth Himelhoch, Anthony Lehman, Julie Kreyenbuhl, Gail Daumit, Clayton Brown, Lisa Dixon
Journal: American Journal of Psychiatry (2004)

Individuals with serious mental illness have elevated smoking rates, and smoking is a significant risk factor for chronic obstructive pulmonary disease (COPD). The goal was to determine the prevalence of COPD among those with serious mental illness.The authors surveyed a random sample of 200 adults with serious mental illness with questions from the National Health and Nutrition Examination Study III that were previously used to estimate the national prevalence of COPD. They compared the prevalence of COPD in the sample to a randomly selected matched subset of national comparison subjects.The prevalence of COPD was 22.6%. Those with serious mental illness were significantly more likely to have chronic bronchitis (19.5% versus 6.1%) and emphysema (7.9% versus 1.5%) than the comparison subjects.The prevalence of COPD is significantly higher among those with serious mental illness than comparison subjects. Improved primary and secondary prevention is warranted.
HIBERNATION AND THE PITUITARY BODY
Authors: Harvey Cushing, Emil Goetsch
Journal: The Journal of Experimental Medicine (1915)

A train of symptoms, coupled with retardation of tissue metabolism and with inactivity of the reproductive glands, not only accompanies states of experimentally induced hypophysial deficiency, but is equally characteristic of clinical states of hypopituitarism. The more notable of these symptoms are a tendency, in the chronic cases, toward an unusual deposition of fat, a lowering of body temperature, slowing of pulse and respiration, fall in blood pressure, and oftentimes a pronounced somnolence. These symptoms bear a marked resemblance to the physiological phenomena accompanying the state of hibernation which have heretofore been unsatisfactorily ascribed solely to extracorporeal factors; namely, a seasonal deprivation of food and low temperature. In a series of hibernating animals (woodchucks) it has been found that during the dormant period histological changes are apparent in many of the ductless glands. The most notable of these changes occur in the pituitary body, as previously observed by Gemelli. The gland not only diminishes in size, but the cells of the pars anterior in some animals at least completely lose their characteristic staining reactions to acid and basic dyes. At the end of the dormant period the gland swells, and as the cells enlarge they again acquire their differential affinity for acid, basic, and neutral stains, and at the same time karyokinetic figures may appear.
<i>Astragalus</i>-Based Chinese Herbs and Platinum-Based Chemotherapy for Advanced Non–Small-Cell Lung Cancer: Meta-Analysis of Randomized Trials
Authors: Michael McCulloch, Caylie See, Xiao-juan Shu, Michael Broffman, Alan Kramer, Wei-yu Fan, Jin Gao, Whitney Lieb, Kane Shieh, John M. Colford
Journal: Journal of Clinical Oncology (2006)

Systemic treatments for advanced non-small-cell lung cancer have low efficacy and high toxicity. Some Chinese herbal medicines have been reported to increase chemotherapy efficacy and reduce toxicity. In particular, Astragalus has been shown to have immunologic benefits by stimulating macrophage and natural killer cell activity and inhibiting T-helper cell type 2 cytokines. Many published studies have assessed the use of Astragalus and other Chinese herbal medicines in combination with chemotherapy. We sought to evaluate evidence from randomized trials that Astragalus-based Chinese herbal medicine combined with platinum-based chemotherapy (versus platinum-based chemotherapy alone) improves survival, increases tumor response, improves performance status, or reduces chemotherapy toxicity.We searched CBM, MEDLINE, TCMLARS, EMBASE, Cochrane Library, and CCRCT databases for studies in any language. We grouped studies using the same herbal combinations for random-effects meta-analysis.Of 1,305 potentially relevant publications, 34 randomized studies representing 2,815 patients met inclusion criteria. Twelve studies (n = 940 patients) reported reduced risk of death at 12 months (risk ratio [RR] = 0.67; 95% CI, 0.52 to 0.87). Thirty studies (n = 2,472) reported improved tumor response data (RR = 1.34; 95% CI, 1.24 to 1.46). In subgroup analyses, Jin Fu Kang in two studies (n = 221 patients) reduced risk of death at 24 months (RR = 0.58; 95% CI, 0.49 to 0.68) and in three studies (n = 411) increased tumor response (RR = 1.76; 95% CI, 1.23 to 2.53). Ai Di injection (four studies; n = 257) stabilized or improved Karnofsky performance status (RR = 1.28; 95% CI, 1.12 to 1.46).Astragalus-based Chinese herbal medicine may increase effectiveness of platinum-based chemotherapy when combined with chemotherapy. These results require confirmation with rigorously controlled trials.
Camping: An Approach to Releasing Human Potential in Chronic Mental Patients
Authors: MAXWELL N. WEISMAN, LENORA MANN, BEN W. BARKER
Journal: American Journal of Psychiatry (1966)

Therapeutic camping for the mentally ill may provide an opportunity for remotivating chronic hospital patients. Two camping sessions initiated by the Maryland Department of Mental Hygiene were attended by 90 state hospital patients, each of whom had been hospitalized for at least two years and appeared to be making no progress in the hospital. Responses of patients to the camping experience were varied; no correlation between diagnosis and the patient's reaction to camping was apparent. However, within three months following the camp sessions, 41 patients were able to be discharged from the hospital.
Aldehydes and Glutathione in Exhaled Breath Condensate of Children with Asthma Exacerbation
Authors: Massimo Corradi, Giuseppina Folesani, Roberta Andreoli, Paola Manini, Alessandro Bodini, Giorgio Piacentini, Silvia Carraro, Stefania Zanconato, Eugenio Baraldi
Journal: American Journal of Respiratory and Critical Care Medicine (2003)

Oxidative stress is implicated in the pathogenesis of asthma, and clinical studies show an imbalance in the level of oxidants to the level of antioxidants in subjects with asthma. Aldehydes and glutathione are examples of biomarkers of oxidant-induced damage and antioxidant status in asthma, respectively. In the study, we applied analytical techniques based on liquid chromatography for the assessment of aldehydes and glutathione in the exhaled breath condensate of children with asthma and in control subjects without asthma. Twelve subjects with asthma were evaluated at exacerbation and after 5 days of therapy with prednisone. At exacerbation, malondialdehyde levels were higher in patients with asthma (30.2 +/- 2.4 nM) than in control subjects (19.4 +/- 1.9 nM, p = 0.002) and were reduced after steroid therapy (18.5 +/- 1.6 nM, p = 0.001). At exacerbation, glutathione levels were lower in subjects with asthma (5.96 +/- 0.6 nM) than in control subjects (14.1 +/- 0.8 nM, p < 0.0001) and were increased after the therapy (8.44 +/- 1.2 nM, p = 0.04). Malondialdehyde and glutathione both in subjects with asthma and control subjects were negatively correlated (r = -0.5, p = 0.001). The study shows that aldehydes and glutathione are detectable in the exhaled breath condensate of children with asthma and healthy children and that their levels are modified during asthma exacerbation and after a 5-day course of therapy with oral prednisone.
Cediranib, an Oral Inhibitor of Vascular Endothelial Growth Factor Receptor Kinases, Is an Active Drug in Recurrent Epithelial Ovarian, Fallopian Tube, and Peritoneal Cancer
Authors: Ursula A. Matulonis, Suzanne Berlin, Percy Ivy, Karin Tyburski, Carolyn Krasner, Corrine Zarwan, Anna Berkenblit, Susana Campos, Neil Horowitz, Stephen A. Cannistra, Hang Lee, Julie Lee, Maria Roche, Margaret Hill, Christin Whalen, Laura Sullivan, Chau Tran, Benjamin D. Humphreys, Richard T. Penson
Journal: Journal of Clinical Oncology (2009)

Purpose Angiogenesis is important for epithelial ovarian cancer (EOC) growth, and blocking angiogenesis can lead to EOC regression. Cediranib is an oral tyrosine kinase inhibitor (TKI) of vascular endothelial growth factor receptor (VEGFR) -1, VEGFR-2, VEGFR-3, and c-kit. Patients and Methods We conducted a phase II study of cediranib for recurrent EOC or peritoneal or fallopian tube cancer; cediranib was administered as a daily oral dose, and the original dose was 45 mg daily. Because of toxicities observed in the first 11 patients, the dose was lowered to 30 mg. Eligibility included ≤ two lines of chemotherapy for recurrence. End points included response rate (via Response Evaluation Criteria in Solid Tumors [RECIST] or modified Gynecological Cancer Intergroup CA-125), toxicity, progression-free survival (PFS), and overall survival (OS). Results Forty-seven patients were enrolled; 46 were treated. Clinical benefit rate (defined as complete response [CR] or partial response [PR], stable disease [SD] &gt; 16 weeks, or CA-125 nonprogression &gt; 16 weeks), which was the primary end point, was 30%; eight patients (17%; 95% CI, 7.6% to 30.8%) had a PR, six patients (13%; 95% CI, 4.8% to 25.7%) had SD, and there were no CRs. Eleven patients (23%) were removed from study because of toxicities before two cycles. Grade 3 toxicities (&gt; 20% of patients) included hypertension (46%), fatigue (24%), and diarrhea (13%). Grade 2 hypothyroidism occurred in 43% of patients. Grade 4 toxicities included CNS hemorrhage (n = 1), hypertriglyceridemia/hypercholesterolemia/elevated lipase (n = 1), and dehydration/elevated creatinine (n = 1). No bowel perforations or fistulas occurred. Median PFS was 5.2 months, and median OS has not been reached; median follow-up time is 10.7 months. Conclusion Cediranib has activity in recurrent EOC, tubal cancer, and peritoneal cancer with predictable toxicities observed with other TKIs.
The Orphan Receptor CRF2-4 Is an Essential Subunit of the Interleukin 10 Receptor
Authors: Susan D. Spencer, Francesco Di Marco, Jeff Hooley, Sharon Pitts-Meek, Michele Bauer, Anne M. Ryan, Bernard Sordat, Verna C. Gibbs, Michel Aguet
Journal: The Journal of Experimental Medicine (1998)

The orphan receptor CRF2-4 is a member of the class II cytokine receptor family (CRF2), which includes the interferon receptors, the interleukin (IL) 10 receptor, and tissue factor. CRFB4, the gene encoding CRF2-4, is located within a gene cluster on human chromosome 21 that comprises three interferon receptor subunits. To elucidate the role of CRF2-4, we disrupted the CRFB4 gene in mice by means of homologous recombination. Mice lacking CRF2-4 show no overt abnormalities, grow normally, and are fertile. CRF2-4 deficient cells are normally responsive to type I and type II interferons, but lack responsiveness to IL-10. By approximately 12 wk of age, the majority of mutant mice raised in a conventional facility developed a chronic colitis and splenomegaly. Thus, CRFB4 mutant mice recapitulate the phenotype of IL-10-deficient mice. These findings suggest that CRF2-4 is essential for IL-10-mediated effects and is a subunit of the IL-10 receptor.
Decisions in the Treatment of Ventricular Ectopic Activity
Authors: Robert J. Myerburg
Journal: JAMA (1978)

EACH use of an antiarrhythmic agent for control of ventricular ectopic activity requires careful consideration of the balance between the indication for use of the drug (based on prognostic implications of ventricular ectopic activity) and undesirable potential side effects that may arise as a result of their use. Side effects include allergic or toxic systemic effects, depression of cardiac mechanical function, paradoxical arrhythmogenesis, and CNS effects; they occur with sufficient frequency, in the context of the limited number of drugs available, to create legitimate concern about appropriate use. The purpose of this communication is to outline settings in which antiarrhythmic agents should or should not be used for various forms of ventricular ectopic activity. The clinical context of ventricular ectopic activity is paramount.  Ischemic Heart Disease  Ventricular ectopic activity in the setting of ischemic heart disease constitutes a risk factor for potentially lethal arrhythmias or sudden death. The effectiveness of