tbuckley/cabot-search huggingface dataset:
Prevalence and Significance of Alterations in Cardiac Structure and Function in Patients With Heart Failure and a Preserved Ejection Fraction
Authors: Michael R. Zile, John S. Gottdiener, Scott J. Hetzel, John J. McMurray, Michel Komajda, Robert McKelvie, Catalin F. Baicu, Barry M. Massie, Peter E. Carson
Journal: Circulation (2011)

The purpose of this study was to examine the prevalence of abnormalities in cardiac structure and function present in patients with heart failure and a preserved ejection fraction (HFPEF) and to determine whether these alterations in structure and function were associated with cardiovascular morbidity and mortality.The Irbesartan in HFPEF trial (I-PRESERVE) enrolled 4128 patients; echocardiographic determination of left ventricular (LV) volume, mass, left atrial (LA) size, systolic function, and diastolic function were made at baseline in 745 patients. The primary end point was death or protocol-specific cardiovascular hospitalization. A secondary end point was the composite of heart failure death or heart failure hospitalization. Associations between baseline structure and function and patient outcomes were examined using univariate and multivariable Cox proportional hazard analyses. In this substudy, LV hypertrophy or concentric remodeling was present in 59%, LA enlargement was present in 66%, and diastolic dysfunction was present in 69% of the patients. Multivariable analyses controlling for 7 clinical variables (including log N-terminal pro-B-type natriuretic peptide) indicated that increased LV mass, mass/volume ratio, and LA size were independently associated with an increased risk of both primary and heart failure events (all P<0.05).Left ventricular hypertrophy or concentric remodeling, LA enlargement, and diastolic dysfunction were present in the majority of patients with HFPEF. Left ventricular mass and LA size were independently associated with an increased risk of morbidity and mortality. The presence of structural remodeling and diastolic dysfunction may be useful additions to diagnostic criteria and provide important prognostic insights in patients with HFPEF.
Isokinetic profile of dorsiflexors and plantar flexors of the ankle--a comparative study of elite versus untrained subjects.
Authors: C H So, T O Siu, K M Chan, M K Chin, C T Li
Journal: British Journal of Sports Medicine (1994)

A comparative study was made of the isokinetic characteristics of the ankle (plantar-flexion and dorsiflexion) in young men. Six cyclists, seven gymnasts, 10 soccer players and 25 non-athletic young men were tested on the Cybex II+ dynamometer. Peak torque, torque acceleration energy (TAE), total work and average power were measured. Cyclists had slightly higher (5%) mean plantar flexion than the others, but this was not significant. The situation was reversed for dorsiflexion. Moreover, the average dorsiflexion per unit of plantar flexion was significantly higher in the gymnasts than it was in the cyclists for both torque and work. This suggests that at a specific level of plantar flexion, the gymnasts had stronger dorsiflexion compared with the cyclists and that in sports involving jumping and running, increased attention should be given to strengthening the antagonist muscle groups (dorsiflexors) in order to achieve greater agonist-to-antagonist muscle balance thus preventing injury. The non-athletic subjects had substantially lower endurance capability in both flexors as measured by the endurance ratio. This implies that identifiable specialization in particular muscles results from training or participating in specialized sports.
Patient and rheumatologist perspectives on glucocorticoids: an exercise to improve the implementation of the European League Against Rheumatism (EULAR) recommendations on the management of systemic glucocorticoid therapy in rheumatic diseases
Authors: M C van der Goes, J W G Jacobs, M Boers, T Andrews, M A M Blom-Bakkers, F Buttgereit, N Caeyers, E H Choy, M Cutolo, J A P Da Silva, L Guillevin, M Holland, J R Kirwan, J Rovensky, K G Saag, G Severijns, S Webber, R Westhovens, J W J Bijlsma
Journal: Annals of the Rheumatic Diseases (2009)

Objective To explore perspectives among patients and rheumatologists on glucocorticoid (GC) therapy and European League Against Rheumatism (EULAR) recommendations on the management of systemic GC therapy in order to enhance implementation of the recommendations. Methods Rheumatologists (from eight countries) and patients (from five countries) acquainted with GCs participated in separate meetings, during which positive and negative aspects of GC therapy were discussed and possible adverse events (AEs) were ranked for importance; in addition participants were asked to evaluate the published EULAR recommendations. The reports from these meetings and themes related to implementation of the recommendations were discussed during an international forum of the experts who had formulated the recommendations and patient participants. Results In all, 140 patients (78% women; mean age 53 years; 61% patients with rheumatoid arthritis) and 110 rheumatologists (mean work experience 15 years) participated in the meetings. Osteoporosis, diabetes and cardiovascular diseases were ranked among the five most worrisome AEs by patients and rheumatologists. In both groups, there was agreement with most of the recommendations; the recommendations on GC information cards and GC use during pregnancy scored lowest. Ideas to improve implementation of the recommendations and a research agenda were generated. Conclusion The patient and rheumatologist views on GCs corresponded to a large extent, reflected by concerns in both groups about osteoporosis, diabetes and cardiovascular diseases. Specific problems with the EULAR recommendations were identified and addressed to improve their implementation. This exercise shows that patient and rheumatologist perspectives should be included early in the process of formulating recommendations.
US scheme prevents some hospital admissions
Authors: Adrian O'Dowd
Journal: BMJ (2005)

The final UK evaluation of a US designed system to manage the care of vulnerable elderly people says that care has improved and the project will continue.

However, it may take more than a year for the Evercare programme to reduce the number of unnecessary hospital admissions, says the final report, which was commissioned by the Department of Health from UnitedHealth Europe, the company that piloted the programme together with nine NHS primary care trusts in England over 17 months. The pilots covered 1333 patients.

The Evercare programme identifies vulnerable elderly patients, who are then allocated to an advanced practice nurse who manages their cases and coordinates all aspects of the patients' care, working with GPs, geriatricians, each patient's family, and social services. The nurse also advises patients in managing their own care.

The report, published last week, looks at the initial outcome of the pilot scheme, which was introduced into the trusts from …
Value of serology in predicting Pseudomonas aeruginosa infection in young children with cystic fibrosis
Authors: T. A. Douglas, S. Brennan, L. Berry, K. Winfield, C. E. Wainwright, K. Grimwood, S. M. Stick, P. D. Sly
Journal: Thorax (2010)

<h3>Background</h3> Early detection of <i>Pseudomonas aeruginosa</i> is essential for successful eradication. The accuracy of serum antibodies against specific and multiple <i>P aeruginosa</i> antigens at predicting lower airway infection in young children with cystic fibrosis (CF) was investigated. <h3>Methods</h3> A commercial <i>P aeruginosa</i> multiple antigen (MAg) ELISA and an in-house exotoxin A (ExoA) ELISA were compared in two populations: a discovery population of 76 children (0.1–7.1 years) undergoing annual bronchoalveolar lavage (BAL)-based microbiological surveillance and a test population of 55 children (0.1–5.6 years) participating in the Australasian CF Bronchoalveolar Lavage Trial. <h3>Results</h3> In the discovery population, <i>P aeruginosa</i> was cultured from BAL fluid (≥10<sup>5</sup> colony-forming units (cfu)/ml) in 15/76 (19.7%) children (median age 1.88 years). Positive MAg and ExoA serological results were found in 38 (50.0%) and 30 (39.5%) children, respectively. Positive (PPV) and negative (NPV) predictive values for serology at diagnosing <i>P aeruginosa</i> infection (≥10<sup>5</sup> cfu/ml) were 0.14 and 0.99 respectively (MAg assay) and 0.11 and 0.98 (ExoA assay). In the test population, <i>P aeruginosa</i> was cultured from BAL fluid (≥10<sup>5</sup> cfu/ml) in 16/55 (29.1%) children (median age 1.86 years) and from oropharyngeal swabs in 32/36 (88.9%). Positive MAg and ExoA serology was detected in 19 (34.5%) and 33 (60.0%) children, respectively. The PPV and NPV of serology were 0.26 and 0.94 respectively (MAg assay) and 0.19 and 0.98 (ExoA assay) and were marginally higher for oropharyngeal cultures. <h3>Conclusions</h3> Measuring serum antibody responses against <i>P aeruginosa</i> is of limited value for detecting early <i>P aeruginosa</i> infection in young children with CF.
Azathioprine: old drug, new actions
Authors: Jonathan S Maltzman, Gary A Koretzky
Journal: Journal of Clinical Investigation (2003)

A knowledge of the biochemical loci of action of 6-MP in the inhibition of nucleic acid synthesis is not sufficient to explain the effects of the thiopurines on the immune system.

—Gertrude B. Elion (Winner of 1988 Nobel Prize in Medicine for “important principals of drug development”; codiscovered 6-MP and azathioprine with George Hitchings) (1)

Azathioprine is among the oldest pharmacologic immunosuppressive agents in use today. Initially developed as a long-lived prodrug of 6-mercaptopurine (6-MP), it was quickly found to have a more favorable therapeutic index. It was soon found that 6-MP could produce remissions in childhood acute leukemia (1), and later, that azathioprine could prolong renal allograft survival (2). Over the past 50 years, azathioprine has been used in the treatment of hematologic malignancies, rheumatologic diseases, solid organ transplantation, and inflammatory bowel disease.

The drug is a purine analog, and the accepted mechanism of action is at the level of DNA (1, 3). Both in vitro and in vivo, azathioprine is metabolized to 6-MP through reduction by glutathione and other sulphydryl-containing compounds and then enzymatically converted into 6-thiouric acid, 6-methyl-MP, and 6-thioguanine (6-TG) (1, 3). Ultimately, azathioprine can then become incorporated into replicating DNA and can also block the de novo pathway of purine synthesis. It is this action that is thought to contribute to its relative specificity to lymphocytes due to their lack of a salvage pathway. However, the effects on the blockade of DNA replication have never fully explained all of the laboratory and clinical findings of azathioprine-induced immunosuppression.
Implications of anti-cytokine therapy in colorectal cancer and autoimmune diseases
Authors: Kepeng Wang, Sergei I Grivennikov, Michael Karin
Journal: Annals of the Rheumatic Diseases (2012)

Up to 20% of all cancers have been linked to chronic inflammation and persistent infections. However, almost all solid tumours contain immune infiltrates, and tumour-associated inflammatory cells play broad roles in different stages of tumour development and malignant progression. Cytokines are important mediators of the inflammatory effect on tumorigenesis both in inflammation-induced cancer and in the inflammation that follows tumour development. We have shown interleukin (IL)-6 to be an important tumour promoter in early colitis-associated cancer (CAC). IL-6 is mainly produced by tumour-infiltrating myeloid cells under the control of NF-κB. IL-6 promotes proliferation of tumour-initiating cells derived from the intestinal epithelium and protects them from apoptotic elimination. These pro-survival and proliferative effects of IL-6 are mainly mediated by STAT3, whose ablation in intestinal epithelial cells significantly reduces CAC tumorigenesis. More recently, we found a critical role for IL-23 and its downstream cytokines IL-17 and IL-22 in the development of CAC. These findings suggest that such cytokines or the cells that produce them may provide new therapeutic or preventive targets in forms of colorectal cancer that are linked to inflammation.
Erytema gyratum repens: spontaneous resolution in a healthy man
Authors: Leslie Stankler
Journal: British Journal of Dermatology (1978)

Journal Article Erytema gyratum repens: spontaneous resolution in a healthy man Get access Leslie Stankler Leslie Stankler University Medical Buildings, Foresterhill, Aberdeen AB9 2ZD Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 99, Issue 4, 1 October 1978, Page 461, https://doi.org/10.1111/j.1365-2133.1978.tb06191.x Published: 01 October 1978
Breast Cancer Survival and Treatment in Health Maintenance Organization and Fee-for-Service Settings
Authors: A. L. Potosky, R. M. Merrill, R. Ballard-Barbash, G. F. Riley, S. H. Taplin, W. Barlow, B. H. Fireman
Journal: JNCI Journal of the National Cancer Institute (1997)

Background: Enrollment in health maintenance organizations (HMOs) has increased rapidly during the past 10 years, reflecting a growing emphasis on health care cost containment. To determine whether there is a difference in the treatment and outcome for female patients with breast cancer enrolled in HMOs versus a fee-for-service setting, we compared the 10-year survival and initial treatment of patients with breast cancer enrolled in both types of plans. Methods: With the use of tumor registries covering the greater San Francisco—Oakland and Seattle—Puget Sound areas, respectively, we obtained information on the treatment and outcome for 13 358 female patients with breast cancer, aged 65 years and older, diagnosed between 1985 and 1992. We linked registry information with Medicare data and data from the two large HMOs included in the study. We compared the survival and treatment differences between HMO and fee-for-service care after adjusting for tumor stage, comorbidity, and sociodemographic characteristics. Results: In San Francisco—Oakland, the 10-year adjusted risk ratio for breast cancer deaths among HMO patients compared with fee-for-service patients was 0.71 (95% confidence interval [CI] = 0.59–0.87) and was comparable for all deaths. In Seattle—Puget Sound, the risk ratio for breast cancer deaths was 1.01 (95% CI = 0.77–1.33) but somewhat lower for all deaths. Women enrolled in HMOs were more likely to receive breast-conserving surgery than women in fee-for-service (odds ratio = 1.55 in San Francisco—Oakland; 3.39 in Seattle). HMO enrollees undergoing breast-conserving surgery were also more likely to receive adjuvant radiotherapy (San Francisco—Oakland odds ratio = 2.49; Seattle odds ratio = 4.62). Conclusions: Long-term survival outcomes in the two prepaid group practice HMOs in this study were at least equal to, and possibly better than, outcomes in the fee-for-service system. In addition, the use of recommended therapy for early stage breast cancer was more frequent in the two HMOs.
Trends in lung cancer, chronic obstructive lung disease, and emphysema death rates for England and Wales 1941-85 and their relation to trends in cigarette smoking.
Authors: P N Lee, J S Fry, B A Forey
Journal: Thorax (1990)

Trends in smoking associated respiratory diseases in England and Wales during 1941-85 have been studied, with careful attention to problems caused by changes in classification of cause of death. Three diseases were selected for analysis: lung cancer, emphysema, and chronic obstructive lung disease. During 1971-85 deaths that would previously have been certified under chronic bronchitis have increasingly tended to be classified under chronic airways obstruction. The definition of chronic obstructive lung disease that was used includes both terms to avoid the artificial decline caused by consideration of chronic bronchitis in isolation. Age specific rates for all three diseases show a pronounced cohort (period of birth) pattern, rates for men rising up to the rates for those born shortly after the turn of the century and then declining, and rates for women peaking in the cohort born 20-25 years later. For chronic obstructive lung disease, but not for lung cancer and emphysema, the cohort peak is superimposed on a sharply declining downward trend. In both sexes cohort patterns of cumulative cigarette consumption peak at a time broadly similar to those seen for the three diseases. Trends in cigarette consumption, however, cannot explain the underlying steeply declining rate of chronic obstructive lung disease. Nor can they fully explain the declining trends in lung cancer and emphysema rates in younger men and women.
Bortezomib: Proteasome Inhibition as an Effective Anticancer Therapy
Authors: Paul G. Richardson, Constantine Mitsiades, Teru Hideshima, Kenneth C. Anderson
Journal: Annual Review of Medicine (2006)

VELCADER (bortezomib, Millennium Pharmaceuticals, Inc., Cambridge, MA, and Johnson & Johnson Pharmaceutical Research & Development, L.L.C., Raritan, NJ) is a first-in-class proteasome inhibitor developed specifically for use as an antineoplastic agent. Inhibition of the proteasome results in disruption of homeostatic mechanisms within the cell that can lead to cell death. Bortezomib's first indication, for the treatment of relapsed myeloma in patients who have received at least two prior treatments and progressed on their previous treatment, was based in part on the magnitude of activity demonstrated in phase II trials. Bortezomib is currently indicated for patients who have received at least one prior therapy in the United States and European Union, although patients in the European Union must have already undergone bone marrow transplantation or be unsuitable for the procedure. A phase III trial demonstrated the superiority of bortezomib over high-dose dexamethasone in response rate, time to progression, and survival in patients with myeloma who had relapsed after 1-3 prior therapies. Clinical development is ongoing to investigate its activity as monotherapy and in combination regimens for the treatment of non-Hodgkin's lymphoma, solid tumors, and earlier presentations of myeloma.
Phase I study of twelve-day prolonged infusion of high-dose ifosfamide and doxorubicin as first-line chemotherapy in adult patients with advanced soft tissue sarcomas
Authors: T. De Pas, G. Curigliano, G. Masci, C. Catania, A. Comandone, C. Boni, A. Tucci, O. Pagani, E. Marrocco, F. de Braud
Journal: Annals of Oncology (2002)
Dietary Changes After Breast Cancer in Women Without Hot Flashes: A Simple and Inexpensive Way to Target Tumor and Host?
Authors: Matteo Puntoni, Bernardo Bonanni, Andrea Decensi
Journal: Journal of Clinical Oncology (2008)

Matteo Puntoni, Medical Oncology Unit, Galliera Hospital; and Biostatistics Unit, Department of Health Sciences, University of Genoa, Genoa, Italy Bernardo Bonanni, Division of Cancer Prevention and Genetics, European Institute of Oncology, Milan, Italy Andrea Decensi, Medical Oncology Unit, Galliera Hospital, Genoa; and Division of Cancer Prevention and Genetics, European Institute of Oncology, Milan, Italy
National Melanoma/Skin Cancer Detection and Prevention Month, May 1996
Journal: JAMA (1996)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Endothelin-1 and Blood Pressure After Inhibition of Nitric Oxide Synthesis in Human Septic Shock
Authors: Jurgen A. M. Avontuur, Frans Boomsma, Anton H. van den Meiracker, Frank H. de Jong, Hajo A. Bruining
Journal: Circulation (1999)

Background —The systemic hypotension during human sepsis has been ascribed to increased production of nitric oxide (NO). Therefore, inhibitors of NO synthesis have been used in the treatment of hypotension in patients with septic shock. In addition, NO production may inhibit the synthesis and vasoconstrictor effects of endothelin-1 (ET-1). In this study, we tested whether ET-1 contributed to the vasopressor action of the NO synthase inhibitor N G -nitro- l -arginine methyl ester (L-NAME) in patients with severe septic shock. Methods and Results —Compared with healthy volunteers, patients with septic shock had increased plasma levels of nitrite/nitrate (37±5 [SEM] versus 12±5 mmol/L, P &lt;0.01), the stable end products of NO metabolism, and ET-1 (45±7 versus 3±2 pg/mL, P &lt;0.001). Plasma ET-1 concentration was not related to plasma nitrite/nitrate concentration or blood pressure. Continuous infusion of L-NAME (1 mg · kg −1 · h −1 IV) for 12 hours increased mean arterial pressure by 43±5% and systemic vascular resistance by 64±10% (both P &lt;0.01). The increase in blood pressure and systemic vascular resistance correlated positively with the level of ET-1 (both P &lt;0.005) but not with plasma nitrite/nitrate level. L-NAME infusion did not result in significant changes in the plasma concentrations of ET-1 or nitrite/nitrate. Conclusions —NO and ET-1 may both play a role in the cardiovascular derangements of human sepsis. Although L-NAME does not increase ET-1 concentration in patients with septic shock, the vasopressor response induced by L-NAME depends on the plasma level of ET-1. These findings may indicate that inhibitors of NO synthesis unmask a tonic pressor response of ET-1 in human septic shock.
Temporal Patterns of Hepatic Dysfunction and Disease Severity in Patients With SARS
Authors: W.-M. Wong
Journal: JAMA (2003)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal