tbuckley/cabot-search huggingface dataset:
Increase in blood glucose concentration during antihypertensive treatment as a predictor of myocardial infarction: population based cohort study
Authors: K. Dunder
Journal: BMJ (2003)

To investigate the impact of an increase in blood glucose on the risk of developing myocardial infarction, with particular emphasis on people taking antihypertensive drugs.Prospective population based cohort study.Uppsala, Sweden.1860 men who had participated in 1970-3 at age 50 in a health survey aimed at identifying risk factors for cardiovascular disease and were re-examined at age 60 and then followed for 17.4 years. MIN OUTCOME MEASURE: Myocardial infarction after age 60.The incidence of myocardial infarction was significantly higher in men treated for hypertension than in those without such treatment (23% v 13.5%, P<0.0001). Participants who developed myocardial infarction after the age of 60 (n=253) showed a significantly larger increase in blood glucose between age 50 and 60 than did those without myocardial infarction. In multivariate Cox proportional hazard models increase in blood glucose was an independent risk factor for myocardial infarction (P=0.0001) in men receiving antihypertensive treatment at age 60 (n=291, mainly beta blockers and thiazide diuretics) but not in those without such treatment. The impact of increase in blood glucose declined after inclusion of serum proinsulin concentrations at baseline but was still significant. A significant interaction existed between proinsulin concentration (a marker of insulin resistance) at baseline and antihypertensive treatment on increase in blood glucose.Increase in blood glucose between the ages of 50 and 60 and baseline proinsulin concentration were important risk factors for myocardial infarction in men receiving antihypertensive treatment, indicating that both an insulin resistant state and the metabolic impact of beta blockers and diuretics increase the risk of myocardial infarction.
Relationship Between Circadian Blood Pressure Patterns and Progression of Early Carotid Atherosclerosis
Authors: Dirk Sander, Christian Kukla, Jürgen Klingelhöfer, Kerstin Winbeck, Bastian Conrad
Journal: Circulation (2000)

Arterial hypertension is a major risk factor for cardiovascular damage. The results of several studies suggest that target organ damage is greater in hypertensive persons with high blood pressure variability.During 3.3 years of follow-up, we studied the relationship between circadian blood pressure changes and the progression of early carotid atherosclerosis in 286 patients aged >55 years. Blood pressure patterns were evaluated with a long-term blood pressure monitor, and the extent of atherosclerosis was measured as the intima-media wall thickness (IMT) of the common carotid artery. Patients were subdivided according to blood pressure variability. The progression of IMT was significantly greater in the patients with increased systolic blood pressure variability (0.11 mm/y [95% CI 0.09 to 0.14] versus 0.05 mm/y [0.03 to 0.08]; P:<0.005) even after adjustment for other risk factors. Multivariate regression analysis revealed the daytime systolic blood pressure variability to be the best predictor for the progression of IMT. Raised daytime systolic blood pressure variability (>15 mm Hg) is associated with an increased relative risk of the development of early atherosclerosis (3.9 [1.4 to 11.1]; P:<0.01) and of cardiovascular events (1.87 [1.08 to 3.20]; P:<0.01).The daytime systolic blood pressure variability is a strong predictor of early carotid atherosclerosis progression and is useful to define the risk-benefit ratio of therapeutic approaches.
Routine duodenal bulb biopsy in coeliac disease: time to change clinical practice?
Authors: K. E. Evans, S. S. Cross, G. R. Sahota, A. D. Hopper, M. Hadjivassiliou, D. S. Sanders
Journal: Gut (2011)

<h3>Introduction</h3> Historically Brunner9s glands were thought to interfere with interpretation of villous atrophy in the duodenal bulb. Recent reports suggest that the duodenal bulb may be the only site to demonstrate villous atrophy (VA) in coeliac disease (CD). There are few data on the prevalence of lesions in non-coeliac patients. <h3>Methods</h3> We aimed to compare the histological findings in the duodenal bulb and distal duodenum of patients with CD against controls having gastroscopy with duodenal biopsy. Indications included positive coeliac serology, family history, diarrhoea, and iron deficiency anaemia. A total of 461 patients were prospectively recruited. Biopsies were graded using the Marsh criteria by a single pathologist blinded to the clinical information. <h3>Results</h3> 461 patients, (300 female, 161 male) median age 50 years (range 16–89) were analysed. 24 patients had VA in the bulb only, 6 had VA in distal duodenum only (p=0.001) (table 1). 1 control patient with HIV enteropathy had VA at both sites. CD in remission showed greater histological variability than new diagnosis CD (p=0.0018) and controls (p=0.0001) <h3>Conclusion</h3> Villous atrophy may be present only in the duodenal bulb. In this study 11/126 (9%) of new diagnosis CD and 12/85 (14%) of CD in remission demonstrated VA in the bulb alone. We recommend taking a biopsy from the bulb as well as the distal duodenum to diagnose suspected coeliac disease and reassess known cases.
Why do patients with congestive heart failure tolerate the initiation of beta-blocker therapy?
Authors: H L Haber, C L Simek, L W Gimple, J D Bergin, K Subbiah, A R Jayaweera, E R Powers, M D Feldman
Journal: Circulation (1993)

BACKGROUND Despite its negative inotropic effects, the initiation of beta-adrenergic blockade is tolerated by patients with congestive heart failure (CHF). Accordingly, we examined the acute hemodynamic effects of beta-adrenergic blockade on systolic and diastolic left ventricular (LV) function and ventriculo-arterial coupling. In addition, isolated myocardium from patients with CHF shows selective beta 1-receptor downregulation, implying a greater role for the beta 2-receptor in maintaining in vivo LV contractility. As a secondary aim, we hypothesized that nonselective beta-adrenergic blockade would have greater negative inotropic effect than beta 1-blockade in patients with CHF. METHODS AND RESULTS Patients with clinical CHF (n = 24) and control patients without CHF (n = 24) were given either the nonselective beta-blocker propranolol or the beta 1-selective blocker metoprolol. LV pressure-volume relations were obtained before and after the administration of intravenous beta-blocker, and measures of LV systolic and diastolic function were examined. Patients with CHF had a deterioration in LV systolic function with a fall in LV systolic pressure (139 +/- 6 to 125 +/- 6 mm Hg), cardiac index (2.56 +/- 0.11 to 2.20 +/- 0.11 mL.min-1 x M-1), dP/dtmax (1173 +/- 63 to 897 +/- 50 mm Hg/s), and end-systolic elastance (0.88 +/- 0.10 to 0.64 +/- 0.10 mm Hg/mL), P &lt; .05 for all. Although there was deterioration of active LV relaxation (isovolumetric relaxation 63 +/- 2 to 73 +/- 3 milliseconds, peak filling rate 543 +/- 33 to 464 +/- 28 mL/s, P &lt; .05 for both), there was no change in passive LV diastolic function (pulmonary capillary wedge, 24 +/- 2 to 24 +/- 1 mm Hg; chamber stiffness, 0.0154 +/- 0.0005 to 0.0163 +/- 0.0005 mL-1, P = NS for both), and a decrease in afterload (arterial elastance 3.85 +/- 0.31 to 3.38 +/- 0.24 mm Hg/mL, P &lt; .05). Control patients had no change in these parameters other than a prolongation of isovolumetric relaxation (48 +/- 1 to 55 +/- 2 milliseconds, P &lt; .05). The effects of propranolol (n = 12) versus metoprolol (n = 12) on these parameters in patients with CHF were similar. CONCLUSIONS These data do not support a greater in vivo physiological role of the myocardial beta 2-receptor in CHF. The preservation of passive diastolic function and ventriculo-arterial coupling provide possible explanations of why beta-adrenergic blockade is tolerated by patients with CHF.
Impact of early access to a palliative/supportive care intervention on pain management in patients with cancer
Authors: E. Bandieri, D. Sichetti, M. Romero, C. Fanizza, M. Belfiglio, L. Buonaccorso, F. Artioli, F. Campione, G. Tognoni, M. Luppi
Journal: Annals of Oncology (2012)
In Vivo Immune Responses of Mice During Carcinogenesis by Ultraviolet Irradiation 2
Authors: Margaret L. Kripke, Jane S. Lofgreen, James Beard, J. Milburn Jessup, Michael S. Fisher
Journal: JNCI Journal of the National Cancer Institute (1977)

In these experiments, we tested in various in vivo assays the immune responses of inbred C3H/HeN(MTV−) (C3H−) mice during carcinogenesis by chronic exposure to UV irradiation. Although the UV-treated mice were unable to reject syngeneic UV-induced tumor transplants, they rejected H-2-incompatible tumor allografts and H-2-compatible skin allografts. The primary hemagglutinin response to sheep red blood cells was normal in these mice, as were the induction of a local graft-versus-host reaction with lymphoid cells from UV-irradiated donors and the induction of an inflammatory response to dimethyl sulfoxide in the footpads of UV-treated mice. An early transient depression of two reactions in UV-irradiated mice occurred: delayed hypersensitivity to dinitrochlorobenzene measured by footpad swelling and the graft-versus-host reaction in UV-irradiated recipients measured by the use of the popliteal lymph node weight gain assay. Both of these reactions returned to a normal level before the development of primary tumors. We concluded that the inability of UV-irradiated mice to reject syngeneic and autochthonous UV-induced tumors was not due to a generalized immunosuppressive effect of chronic UV irradiation.
An evaluation of brush biopsy in the diagnosis of peripheral pulmonary lesions
Authors: G. H. Smith, A. J. N. Warrack
Journal: Thorax (1972)

A method of abrasive biopsy of the peripheral bronchial tree is described. Forty-nine patients with peripheral pulmonary lesions have been investigated, and at bronchoscopy brush biopsies have been performed. In 13 cases a firm diagnosis of bronchial carcinoma was made and in nine patients atypical cells were reported. Two of the latter were found on further investigation to have had no carcinoma and one showed squamous metaplasia only on surgical biopsy. In nine patients a false negative result was obtained. These results suggest that the routine use of brush biopsy during bronchoscopy performed in the investigation of peripheral pulmonary lesions helps to increase the accuracy of diagnosis.
Effects of Interleukin-13 Blockade on Allergen-induced Airway Responses in Mild Atopic Asthma
Authors: Gail M Gauvreau, Louis-Philippe Boulet, Donald W Cockcroft, J Mark Fitzgerald, Chris Carlsten, Beth E Davis, Francine Deschesnes, MyLinh Duong, Billie L Durn, Karen J Howie, Linda Hui, Marion T Kasaian, Kieran J Killian, Tara X Strinich, Richard M Watson, Nathalie Y, Simon Zhou, Donald Raible, Paul M O'Byrne
Journal: American Journal of Respiratory and Critical Care Medicine (2010)

Extensive evidence in animal models supports a role for IL-13 in the pathobiology of asthma. IMA-638 and IMA-026 are fully humanized IgG(1) antibodies that bind to different epitopes and neutralize IL-13 bioactivity.We hypothesized that anti-IL-13 treatment would inhibit allergen-induced late-phase asthmatic responses, airway hyperresponsiveness, and inflammation in subjects with asthma.Fifty-six subjects with mild, atopic asthma were recruited for two double-blind, randomized, placebo-controlled, parallel group trials to compare IMA-638 and IMA-026 IL-13 antibody treatments with placebo treatment. Drug was administered on Days 1 and 8, and allergen challenges were performed on Days 14 and 35. The primary outcome variable was the late-phase area under the curve (AUC), and secondary outcome variables were the early- and late-phase maximum percent fall in FEV(1), early AUC, allergen-induced shift in airway hyperresponsiveness, and sputum eosinophils.The treatment difference with IMA-638 on Day 14 was -19.1 FEV(1) × hour (95% confidence interval: -36.2, -1.9) for the allergen-induced early AUC and -23.8 FEV(1) × hour (95% confidence interval: -46.4, -1.2) for the late AUC (both P < 0.05), but this effect was lost by Day 35. Treatment with IMA-026 did not attenuate the asthmatic responses on Day 14 or Day 35. There was no effect of either antibody on allergen-induced airway hyperresponsiveness or sputum eosinophils. The frequency of adverse events after administration of the IL-13 antibodies was similar to placebo.IL-13 has a role in allergen-induced airway responses in humans. Further study is required to determine whether anti-IL-13 monoclonal antibodies will be beneficial clinically.
Age-dependency of surfactant phospholipids and surfactant protein A in bronchoalveolar lavage fluid of children without bronchopulmonary disease
Authors: F Ratjen, B Rehn, U Costabel, J Bruch
Journal: European Respiratory Journal (1996)

Whilst alterations in surfactant components of bronchoalveolar lavage fluid (BALF) have been described in a variety of pulmonary diseases in adults, no information is available on the surfactant composition in children beyond the neonatal period. In order to obtain reference values for the paediatric age group, we have studied phospholipid profiles of BALF in children without pulmonary disease. The study population consisted of 38 children aged 3-15 yrs (mean +/- SD 8 +/- 4 yrs) undergoing elective surgery for nonpulmonary illnesses. Surfactant composition was analysed by high pressure liquid chromatography using both an ultraviolet and a light-scattering detector. Total phospholipid concentration was higher in children under 8 yrs of age and decreased with age. In contrast, the total protein concentration remained constant throughout the age range. No age-related changes in the relative composition of phospholipid fractions could be observed. Surfactant protein A concentrations were highly variable in all age groups. This study provides the first data on surfactant components in bronchoalveolar lavage fluid of healthy children and will be the basis for future studies of children with pulmonary diseases.
Comparative study of short-term recovery of mental efficiency after anaesthesia.
Authors: J E Simpson, C J Glynn, A G Cox, S Folkard
Journal: BMJ (1976)

Two common general anaesthetic techniques were compared to evaluate the time taken for the patient9s mental efficiency to recover sufficiently for him to be escorted home after inguinal herniorrhaphy. Recovery in performance efficiency to at least 60% of the patient9s own maximum is suggested as a criterion for discharge, and this needs a stay in hospital of seven to nine hours.
Prostaglandin E production by human blood monocytes and mouse peritoneal macrophages.
Authors: J I Kurland, R Bockman
Journal: The Journal of Experimental Medicine (1978)

Purified populations of both human peripheral blood monocytes and murine peritoneal macrophages synthesize and release Prostaglandin E in vitro. In contrast, prostaglandin E was detected in neither the supernate fluids from cultures of highly enriched human lymphocytes and granulocytes, nor in nonadherent murine peritoneal cells. Macrophage prostaglandin E production was markedly enhanced by endotoxin, and completely suppressed by indomethacin. All neoplastic monocyte-macrophage cell lines examined elaborated prostaglandin E in vitro, either constitutively or after induction with endotoxin. In contrast, prostaglandin E production could not be detected from either a T- or B-cell lymphoma, whether or not they were treated with endotoxin. These findings thus indicate that the blood monocyte and tissue macrophage represent an important source of prostaglandin E, a function shared by both normal and neoplastic mononuclear phagocytes.
Patients with Cluster A Personality Disorders in Psychotherapy: An Effectiveness Study
Authors: Anna Bartak, Helene Andrea, Marieke D. Spreeuwenberg, Moniek Thunnissen, Uli M. Ziegler, Jack Dekker, Fleur Bouvy, Elisabeth F.M. Hamers, Anke M.M.A. Meerman, Jan J.V. Busschbach, Roel Verheul, Theo Stijnen, Paul M.G. Emmelkamp
Journal: Psychotherapy and Psychosomatics (2010)

&lt;i&gt;Background:&lt;/i&gt; While psychopharmacological studies are common in patients with cluster A personality disorders, the effects of psychotherapy have received little attention. The aim of this study is to explore whether psychotherapeutic treatment yields health gains for these patients. &lt;i&gt;Methods:&lt;/i&gt; The study was conducted between March 2003 and June 2008 in 6 mental health care centres in the Netherlands, with a sample of 57 patients with a DSM-IV-TR axis II cluster A diagnosis. Patients were assigned to 3 settings of psychotherapeutic treatment (outpatient, day hospital, inpatient), and effectiveness was assessed at 18 months after baseline. An intention-to-treat analysis was conducted for psychiatric symptoms (Brief Symptom Inventory), psychosocial functioning (Outcome Questionnaire-45) and quality of life (EQ-5D), using multilevel statistical modelling. As the study was non-randomised, the propensity score method was used to control for initial differences. &lt;i&gt;Results:&lt;/i&gt; Patients in the day hospital and inpatient group improved substantially in terms of psychiatric symptoms, social and interpersonal functioning, and quality of life. Patients in the outpatient group showed less improvement. Direct comparison of the improvement of psychiatric symptoms showed significant results in favour of day hospital (p = 0.046) and inpatient (p = 0.01) treatment, as compared to outpatient treatment. However, due to substantial baseline differences, this direct comparison should be judged carefully. &lt;i&gt;Conclusions:&lt;/i&gt; Cluster A psychopathology is not a contraindication to benefit from psychotherapy. This is especially true for more intensive forms like inpatient and day hospital treatment. Future research should focus more on psychotherapeutic treatment to gain further insight into effective treatment options for this patient group.
A Novel Inhibitory Receptor (ILT3) Expressed on Monocytes, Macrophages, and Dendritic Cells Involved in Antigen Processing
Authors: Marina Cella, Christian Döhring, Jacqueline Samaridis, Mark Dessing, Manfred Brockhaus, Antonio Lanzavecchia, Marco Colonna
Journal: The Journal of Experimental Medicine (1997)

Immunoglobulin-like transcript (ILT) 3 is a novel cell surface molecule of the immunoglobulin superfamily, which is selectively expressed by myeloid antigen presenting cells (APCs) such as monocytes, macrophages, and dendritic cells. The cytoplasmic region of ILT3 contains putative immunoreceptor tyrosine-based inhibitory motifs that suggest an inhibitory function of ILT3. Indeed, co-ligation of ILT3 to stimulatory receptors expressed by APCs results in a dramatic blunting of the increased [Ca2+]i and tyrosine phosphorylation triggered by these receptors. Signal extinction involves SH2-containing protein tyrosine phosphatase 1, which is recruited by ILT3 upon cross-linking. ILT3 can also function in antigen capture and presentation. It is efficiently internalized upon cross-linking, and delivers its ligand to an intracellular compartment where it is processed and presented to T cells. Thus, ILT3 is a novel inhibitory receptor that can negatively regulate activation of APCs and can be used by APCs for antigen uptake.
Disruption in the temporal sequence of regional ventricular contraction. I. Characteristics and incidence in coronary artery disease.
Authors: B L Holman, J Wynne, J Idoine, J Neill
Journal: Circulation (1980)

While spatial asynergy at end-systole has been well characterized in patients with coronary artery disease, assessment of regional asynchrony has been hampered by technical constraints. We developed a computer-assisted method for analyzing regional asynchrony from the equilibrium (ECG-gated) radionuclide ventriculogram. Twenty patients with normal contrast left ventriculograms (nine with a normal coronary arteriogram [group 1] and 11 with coronary artery disease [group 2]) and 20 patients with asynergy during contrast ventriculography (group 3) were studied. The earliest evidence of regional asynchrony occurred in early systole. Regional ejection fraction at one-third systole was 0.32 +/- 0.02 (mean +/- SEM) in group 1, 0.22 +/- 0.01 in group 2 (p less than 0.001) and 0.12 +/- 0.01 in asynergic regions in group 3 patients (p less than 0.001). In group 3, severe forms of regional asynchrony appeared in both early systole and early diastole: five patients (25%) had early systolic paradox, 13 (65%) had regional prolongation of peak ejection fraction and 16 (80%) had reduced percent peak ejection fraction at global end-systole. It appears, therefore, that there is progressively increasing regional asynchrony in patients with increasing severity of coronary artery disease.
Undifferentiated arthritis characteristics and outcomes when applying the 2010 and 1987 criteria for rheumatoid arthritis
Authors: A Krabben, T W J Huizinga, A H M van der Helm-van Mil
Journal: Annals of the Rheumatic Diseases (2011)

Undifferentiated arthritis (UA) is a diagnosis 'per exclusionem'. Therefore this patient population may change since the development of the ACR/EULAR 2010-criteria for RA. This study evaluated characteristics and outcomes of UA in its new shape. Second, it was evaluated whether the 2010-criteria and the Leiden prediction rule were congruent in categorizing UA-patients.2,472 early arthritis patients were studied. RA was classified according to either the 1987 or the 2010-criteria. UA was defined as not fulfilling existing classification criteria. UA-patients were compared for baseline characteristics and outcomes. In 1987-UA-patients both the 2010-criteria and the Leiden prediction rule were applied and categorization compared.2010-UA-patients (n=776) had milder baseline characteristics than 1987-UA-patients (n=1,166). During follow-up, still 24% of the 2010-UA-patients fulfilled the 1987 RA-criteria compared to 32% of the 1987-UA-patients. The 2010-UA-patients started less frequent DMARD-therapy and reached more frequent sustained DMARD-free remission. 30% of 2010-criteria-positive patients were predicted to have a low risk on RA; these patients achieved more frequent DMARD-free sustained remission than other 2010-criteria-positive patients.UA in the era of the 2010-criteria is less prevalent and milder at presentation and in outcome. This implies that UA-patients with unfavorable characteristics are now more often classified as RA.