tbuckley/cabot-search huggingface dataset:
Ferric Gluconate Is Highly Efficacious in Anemic Hemodialysis Patients with High Serum Ferritin and Low Transferrin Saturation
Authors: Daniel W. Coyne, Toros Kapoian, Wadi Suki, Ajay K. Singh, John E. Moran, Naomi V. Dahl, Adel R. Rizkala
Journal: Journal of the American Society of Nephrology (2007)

Few data exist to guide treatment of anemic hemodialysis patients with high ferritin and low transferrin saturation (TSAT). The Dialysis Patients' Response to IV Iron with Elevated Ferritin (DRIVE) trial was designed to evaluate the efficacy of intravenous ferric gluconate in such patients. Inclusion criteria were hemoglobin <or=11 g/dl, ferritin 500 to 1200 ng/ml, TSAT <or=25%, and epoetin dosage >or=225 IU/kg per wk or >or=22,500 IU/wk. Patients with known infections or recent significant blood loss were excluded. Participants (n=134) were randomly assigned to no iron (control) or to ferric gluconate 125 mg intravenously with eight consecutive hemodialysis sessions (intravenous iron). At randomization, epoetin was increased 25% in both groups; further dosage changes were prohibited. At 6 wk, hemoglobin increased significantly more (P=0.028) in the intravenous iron group (1.6 +/- 1.3 g/dl) than in the control group (1.1 +/- 1.4 g/dl). Hemoglobin response occurred faster (P=0.035) and more patients responded after intravenous iron than in the control group (P=0.041). Ferritin <or=800 or >800 ng/ml had no relationship to the magnitude or likelihood of responsiveness to intravenous iron relative to the control group. Similarly, the superiority of intravenous iron compared with no iron was similar whether baseline TSAT was above or below the study median of 19%. Ferritin decreased in control subjects (-174 +/- 225 ng/ml) and increased after intravenous iron (173 +/- 272 ng/ml; P<0.001). Intravenous iron resulted in a greater increase in TSAT than in control subjects (7.5 +/- 7.4 versus 1.8 +/- 5.2%; P<0.001). Reticulocyte hemoglobin content fell only in control subjects, suggesting worsening iron deficiency. Administration of ferric gluconate (125 mg for eight treatments) is superior to no iron therapy in anemic dialysis patients receiving adequate epoetin dosages and have a ferritin 500 to 1200 ng/ml and TSAT <or=25%.
A 29-year-old male with chest pain and haemoptysis
Authors: E. C. Young, N. L. Mills, P. A. Henriksen, J. T. Murchison, D. M. Salter, R. L. Hayward, D. E. Newby, A. J. Simpson
Journal: European Respiratory Journal (2008)

A 29-yr-old African male was admitted with a 1-week history of chest pain, shortness of breath and haemoptysis. He had returned from Africa by plane 2 weeks previously. The patient denied fever, sweats or weight loss. He had no significant past medical history, was not taking any regular medication, and was a lifelong nonsmoker. He lived in the UK and was in full-time education.

Physical examination did not reveal any abnormalities. Laboratory investigations showed elevated inflammatory markers, including an erythrocyte sedimentation rate level of 59 mm·h−1 and a C-reactive protein level of 53 mg·L−1, normal haemoglobin at 139 g·L−1 and leukocytosis of 14.6×109·L−1 with a predominance of neutrophils. Chest radiograph was normal. Computed tomography (CT) pulmonary angiography confirmed the presence of filling defects within branches of the right lower lobe, left lingular and left lower lobe pulmonary arteries, with no radiological evidence of right heart strain. Small nodules of ≤7 mm were identified in both lungs (fig. 1⇓). Several small mediastinal nodes were also identified. The patient was anti-coagulated with warfarin for bilateral pulmonary thromboembolism.



Fig. 1— 
Computed tomography pulmonary angiography. Arrows show small pulmonary nodules.



The patient had further episodes of atypical chest pain and haemoptysis over the following month. He was readmitted with signs of right heart failure and normocytic …
Eosinophilic pneumonia in an asthmatic patient treated with omalizumab therapy: <i>forme‐fruste</i> of Churg‐Strauss syndrome?
Authors: M. Cazzola, M. Mura, A. Segreti, M. A. Mattei, P. Rogliani
Journal: Allergy (2009)

Allergy to atropine means a difficulty for future anaesthesia procedures, because of its use in the premedication to avoid vagal reflex during surgery, and to help eliminating the airways secretions.The alternative to atropine would be the glycopyrrolate, not commercialised in some countries; otherwise an alpha-beta blocker could be used, such as Ephedrine, in case of vagal complications during the intervention.The alternative mydriatic drugs to atropine would be the phenylephrine and the adrenaline.This case highlights once again the reliability of BAT in the diagnosis of drug allergy (4, 5).
Association of systemic psoriasis therapies and incidence of myocardial infarction
Authors: J.J. Wu, J.C. Channual, F. Dann
Journal: British Journal of Dermatology (2011)

Funding sources: None. Conflicts of interest: J.C.C. and F.D., none declared. J.J.W. has received research funding from Abbott Laboratories, Amgen and Pfizer, which were not directly related to this letter. Madam, We read with much interest the article by Abuabara et al.1 on the effect of systemic psoriasis therapies on the incidence of myocardial infarction (MI). Using the database of a large U.S. insurer that included 25 554 patients with psoriasis receiving systemic treatment or phototherapy, this study is one of the first in the literature to examine this question. We laud the authors for their efforts in the study, but we believe that the authors’ conclusion that there does not appear to be a reduced risk of MI in patients with psoriasis receiving systemic therapy compared with a group undergoing phototherapy is incorrect based on flaws in the study design. The therapies studied and methods of analysis raise several concerns. The authors compared the risk of acute MI in patients receiving ‘systemic therapies’ (methotrexate, ciclosporin, alefacept, efalizumab, adalimumab, etanercept and infliximab) with those receiving ultraviolet (UV) B phototherapy. There is some evidence that methotrexate2 and tumour necrosis factor (TNF)‐α inhibitors may reduce MI risk (Wu JJ, Poon KT, Dann F et al. Association between TNF‐α inhibitor therapy and myocardial infarction risk in patients with psoriasis. Submitted for publication). Ciclosporin increases blood pressure and lipids, and efalizumab raises C‐reactive protein,3 a marker for inflammation, increasing the risk for MI. Therefore, grouping all systemic therapy together to compare against phototherapy is not ideal as the benefits of one systemic therapy may mask the risks of another. Secondly, due to the intrinsic differences in the nature of the therapies and the economic windfall, the more important question to be asked is whether TNF‐α inhibitor therapy may reduce the risk of MI incidence when compared with oral therapy or phototherapy. The systemic therapy acitretin was not included in the study. Acitretin may increase triglyceride levels, which could affect MI risk. There was no mention of psoralen + UVA therapy (PUVA). PUVA can be considered a systemic therapy due to ingestion of psoralen prior to exposure to UVA, but it can also be considered phototherapy. There is no reconciliation of which cohort patients treated with PUVA might have been grouped.
Patterns of Insertion and Deletion in Contrasting Chromatin Domains
Authors: Justin P. Blumenstiel, Daniel L. Hartl, Elena R. Lozovsky
Journal: Molecular Biology and Evolution (2002)

Transposable elements (TEs) play a fundamental role in the evolution of genomes. In Drosophila they are disproportionately represented in regions of low recombination, such as in heterochromatin. This pattern has been attributed to selection against repeated elements in regions of normal recombination, owing to either (1) the slightly deleterious position effects of TE insertions near or into genes, or (2) strong selection against chromosomal abnormalities arising from ectopic exchange between TE repeats. We have used defective non-long-terminal repeat (LTR) TEs that are "dead-on-arrival" (DOA) and unable to transpose in order to estimate spontaneous deletion rates in different constituents of chromatin. These elements have previously provided evidence for an extremely high rate of spontaneous deletion in Drosophila as compared with mammals, potentially explaining at least part of the differences in the genome sizes in these organisms. However, rates of deletion could be overestimated due to positive selection for a smaller likelihood of ectopic exchange. In this article, we show that rates of spontaneous deletion in DOA repeats are as high in heterochromatin and regions of euchromatin with low recombination as they are in regions of euchromatin with normal recombination. We have also examined the age distribution of five non-LTR families throughout the genome. We show that there is substantial variation in the historical pattern of transposition of these TEs. The overrepresentation of TEs in the heterochromatin is primarily due to their longer retention time in heterochromatin, as evidenced by the average time since insertion. Fragments inserted recently are much more evenly distributed in the genome. This contrast demonstrates that the accumulation of TEs in heterochromatin and in euchromatic regions of low recombination is not due to biased transposition but by greater probabilities of fixation in these regions relative to regions of normal recombination.
Complete FcRn dependence for intravenous Ig therapy in autoimmune skin blistering diseases
Authors: N. Li
Journal: Journal of Clinical Investigation (2005)

Numerous mechanisms of action have been proposed for intravenous Ig (IVIG). In this study, we used IgG passive transfer murine models of bullous pemphigoid (BP), pemphigus foliaceus (PF), and pemphigus vulgaris (PV) to test the hypothesis that the effect of IVIG in autoantibody-mediated cutaneous bullous diseases is to accelerate the degradation of pathogenic IgG by saturation of the MHC-like Fc receptor neonatal Fc receptor (FcRn). BP, PF, and PV are organ-specific antibody-mediated diseases in which autoantibodies target the hemidesmosomal antigen BP180 and desmosomal antigens Dsg1 and Dsg3, respectively. Antibodies against BP180, Dsg1, and Dsg3, when injected into neonatal mice, induce the BP, PF, and PV disease phenotypes, respectively. We found that FcRn-deficient mice were resistant to experimental BP, PF, and PV. Circulating levels of pathogenic IgG in FcRn-deficient mice were significantly reduced compared with those in WT mice. Administration of high-dose human IgG (HDIG) to WT mice also drastically reduced circulating pathogenic IgG levels and prevented blistering. In FcRn-deficient mice, no additional protective effect with HDIG was realized. These data demonstrate that the therapeutic efficacy of HDIG treatment in the pemphigus and pemphigoid models is dependent on FcRn. Thus, FcRn is a promising therapeutic target for treating such IgG-mediated autoimmune diseases.
Methadone Versus Morphine As a First-Line Strong Opioid for Cancer Pain: A Randomized, Double-Blind Study
Authors: Eduardo Bruera, J. Lynn Palmer, Snezana Bosnjak, Maria Antonieta Rico, Jairo Moyano, Catherine Sweeney, Florian Strasser, Jie Willey, Mariela Bertolino, Clarissa Mathias, Odette Spruyt, Michael J. Fisch
Journal: Journal of Clinical Oncology (2003)

To compare the effectiveness and side effects of methadone and morphine as first-line treatment with opioids for cancer pain.Patients in international palliative care clinics with pain requiring initiation of strong opioids were randomly assigned to receive methadone (7.5 mg orally every 12 hours and 5 mg every 4 hours as needed) or morphine (15 mg sustained release every 12 hours and 5 mg every 4 hours as needed). The study duration was 4 weeks.A total of 103 patients were randomly assigned to treatment (49 in the methadone group and 54 in the morphine group). The groups had similar baseline scores for pain, sedation, nausea, confusion, and constipation. Patients receiving methadone had more opioid-related drop-outs (11 of 49; 22%) than those receiving morphine (three of 54; 6%; P =.019). The opioid escalation index at days 14 and 28 was similar between the two groups. More than three fourths of patients in each group reported a 20% or more reduction in pain intensity by day 8. The proportion of patients with a 20% or more improvement in pain at 4 weeks in the methadone group was 0.49 (95% CI, 0.34 to 0.64) and was similar in the morphine group (0.56; 95% CI, 0.41 to 0.70). The rates of patient-reported global benefit were nearly identical to the pain response rates and did not differ between the treatment groups.Methadone did not produce superior analgesic efficiency or overall tolerability at 4 weeks compared with morphine as a first-line strong opioid for the treatment of cancer pain.
Incubation period as part of the case definition of severe respiratory illness caused by a novel coronavirus
Authors: H Nishiura, K Mizumoto, M Ejima, Y Zhong, B J Cowling, R Omori
Journal: Eurosurveillance (2012)

Non-specific symptoms of acute respiratory viral infections make it difficult for many countries without ongoing transmission of a novel coronavirus to rule out other possibilities including influenza before isolating imported febrile individuals with a possible exposure history. The incubation period helps differential diagnosis, and up to two days is suggestive of influenza. It is worth including the incubation period in the case definition of novel coronavirus infection.
Reticuloendothelial System Phagocytic Activity in Cirrhosis and Its Relation to Bacterial Infections and Prognosis†
Authors: Antoni Rimola, Ramón Soto, Felipe Bory, Vicente Arroyo, Carlos Piera, Joan Rodes
Journal: Hepatology (1984)

The reticuloendothelial system phagocytic activity, estimated by the plasma elimination rate constant of 99mtechnetium-sulfur colloid, was studied in 41 decompensated cirrhotics and 10 normal subjects. The results were related to the incidence and type of bacterial infections occurring during hospitalization and follow-up, and to survival. The elimination rate constant of 99mtechnetium-sulfur colloid was lower in cirrhotic patients (0.168 +/- 0.007) (means +/- S.E.) than in normal subjects (0.220 +/- 0.005) (p less than 0.01). Cirrhotics were divided into two groups. Group I (16 patients) and Group II (25 patients) had normal or reduced elimination rate constant of 99mtechnetium-sulfur colloid, respectively. Both groups were similar in relation to clinical and biochemical data, hepatic blood flow, and wedged hepatic venous pressure. However, the liver scan and the elimination rate constant of indocyanine green were more altered in Group II. Patients in Group II developed acute bacterial infections more frequently than did patients in Group I. During hospitalization (24 +/- 2 days), bacteremia occurred in six patients in Group II and in none in Group I (p less than 0.05). During follow-up (28 +/- 3 months), 5 patients in Group II and none in Group I developed bacteremia (p less than 0.05). The cumulative survival rate of Group I patients was higher (p less than 0.05) than that of Group II patients at 3 months (100 vs. 80%), 6 months (94 vs. 68%), 24 months (74 vs. 42%), and 48 months (68 vs. 34%). We suggest that decompensated cirrhotics with depressed reticuloendothelial system phagocytic activity are at great risk to acquire bacteremia, and that reticuloendothelial system phagocytic activity has prognostic value in cirrhosis.
Expression of the DNAM-1 ligands, Nectin-2 (CD112) and poliovirus receptor (CD155), on dendritic cells: relevance for natural killer-dendritic cell interaction
Authors: Daniela Pende, Roberta Castriconi, Paola Romagnani, Grazia Maria Spaggiari, Stefania Marcenaro, Alessandra Dondero, Elena Lazzeri, Laura Lasagni, Stefania Martini, Paola Rivera, Andrea Capobianco, Lorenzo Moretta, Alessandro Moretta, Cristina Bottino
Journal: Blood (2005)
Relation between diagnoses on severity, sick leave and loss of job among patients with occupational hand eczema
Authors: R.S. Cvetkovski, K.J. Rothman, J. Olsen, B. Mathiesen, L. Iversen, J.D. Johansen, T. Agner
Journal: British Journal of Dermatology (2005)

Epidemiological studies indicate that occupational hand eczema (OHE) often is associated with persistent dermatitis and prolonged sick leave, which may lead to unemployment. Previous studies suggest that OHE caused by allergic contact dermatitis and atopic dermatitis (AD) carries the worst prognosis.To evaluate and compare the severity and consequences of recognized OHE in different diagnostic and subdiagnostic groups.Between October 2001 and November 2002, all new cases of recognized OHE were identified from the Danish National Board of Industrial Injuries Registry (758 cases). Severity was graded from 0 to 2 depending on the intensity of skin response and the frequency of relapse. To supplement the information from the Registry, we surveyed the study population using a postal questionnaire which included questions about disease duration, sick leave, current occupation and loss of job.The overall response rate to the questionnaire was 82%. We observed substantially greater severity among those with occupational irritant contact dermatitis (ICD) and AD than for any other diagnoses. Age above 50 years was also associated with increased severity of OHE. Prolonged sick leave due to OHE was reported by 19.9% and was associated with AD and severe OHE. We found a higher proportion of prolonged sick leave among those in food-related occupations (27.2%) compared with those in wet occupations (20.1%) and other occupations (16.5%). Twenty-three per cent reported that they had lost their job at least once during the past 12 months due to OHE. The only strong association with loss of job was food-related occupations.Occupational ICD and AD appear to be strongly associated with severity of OHE. AD and severity of OHE were independently associated with prolonged sick leave. Having a food-related occupation appears to be associated with increased risk of loss of job.
PTH-059 Upper Gastrointestinal Malignancies: 6976 Endoscopy Review in a Multinational Study
Authors: S Roy
Journal: Gut (2013)

<h3>Introduction</h3> To compare the prevalence of upper gastrointestinal (UGI) malignant and premalignant conditions in three separate populations; British, Japanese and Arabian. <h3>Methods</h3> 6976 Upper Gastrointestinal (UGI) endoscopies were retrospectively reviewed in a multinational comparative study. This involved three population groups: Group A- British &amp; others (n = 2158); Group B- Japanese (n = 2628); Group C- Arabians (Saudi Arabians &amp; others (n = 2190)). The majority of the patients fell in the above 16 age group. The patients presented with UGI symptoms and were selected at random. The data was collected between 1986 and 2012. The study involved patients from Barnsley District General Hospital (Barnsley), Darent Valley Hospital (Dartford) &amp; Queen Mary’s Hospital (Sidcup) in UK - Group A; Showa University Fujigaoka Hospital &amp; Niigata Cancer Centre Hospital (Japan)- Group B; Jubail Hospitals (Saudi Arabia) – Group C. <h3>Results</h3> A comparison was made for the malignant and premalignant diseases. It revealed a very high incidence of UGI malignancies amongst Japanese (Group B). There is significant number of malignant diseases amongst non-Arabians, but such malignancies amongst Arabians are rare. The incidence of gastric ulcers and gastric polyps are very high amongst Japanese compared to the other population groups in the study. It is found that the prevalence of Barrett’s Oesophagus has increased significantly in the last ten years. The results are summarised as below: UGI malignancies recorded: Group A: British population: 37 (1.71% with 95% CI: 1.17 to 2.26) Group B: Japanese population: 148 (5.63% with 95% CI: 4.75 to 6.51) Group C: Arabian population: 16 (1.17% with 95% CI: 1.17 to 2.26) Ulcers in the upper GI tract recorded: Group A: British population: 366 (16.96%, 95% CI: 15.38 to 18.54) Group B: Japanese population: 498 (18.95% 95% CI: 17.45 to 20.45) Group C: Saudi population: 506 (23.11%, 95% CI = 21.34 to 24.87). <h3>Conclusion</h3> It can be concluded that Arabians (Saudis) suffer rarely from UGI malignancies and it may be related to social, environmental, geographical, genetic and dietary habits. Dietary habits in Japan are very different from the British and Saudi population. Alcohol consumption amongst Saudis is very little. In comparison, Japanese and UK populations drink alcohol significantly more. Prevalence of Barrett’s has increased significantly in the last 10 years. It is likely due to effective Helicobacter Pylori eradication and due to increasing awareness of Barrett’s amongst endoscopists. <h3>Disclosure of Interest</h3> None Declared.
Vaccination of rhesus monkeys with synthetic peptide in a fusogenic proteoliposome elicits simian immunodeficiency virus-specific CD8+ cytotoxic T lymphocytes.
Authors: M D Miller, S Gould-Fogerite, L Shen, R M Woods, S Koenig, R J Mannino, N L Letvin
Journal: The Journal of Experimental Medicine (1992)

An effective vaccine against the human immunodeficiency virus should be capable of eliciting both an antibody and a cytotoxic T lymphocyte (CTL) response. However, when viral proteins and peptides are formulated with traditional immunological adjuvants and inoculated via a route acceptable for use in humans, they have not been successful at eliciting virus-specific, major histocompatibility complex (MHC) class I-restricted CTL. We have designed a novel viral subunit vaccine by encapsulating a previously defined synthetic peptide CTL epitope of the simian immunodeficiency virus (SIV) gag protein within a proteoliposome capable of attaching to and fusing with plasma membranes. Upon fusing, the encapsulated contents of this proteoliposome can enter the MHC class I processing pathway through the cytoplasm. In this report, we show that after a single intramuscular vaccination, rhesus monkeys develop a CD8+ cell-mediated, MHC class I-restricted CTL response that recognizes the synthetic peptide immunogen. The induced CTL also demonstrate antiviral immunity by recognizing SIV gag protein endogenously processed by target cells infected with SIV/vaccinia recombinant virus. These results demonstrate that virus-specific, MHC class I-restricted, CD8+ CTL can be elicited by a safe, nonreplicating viral subunit vaccine in a primate model for acquired immune deficiency syndrome. Moreover, the proteoliposome vaccine formation described can include multiple synthetic peptide epitopes, and, thus, offers a simple means of generating antiviral cell-mediated immunity in a genetically heterogeneous population.