tbuckley/cabot-search huggingface dataset:
Abstract 3791: Improved Ventricular-Arterial Coupling After 4 Weeks of Exercise Training in Patients with Chronic Heart Failure
Authors: Marcus Sandri, Stephan Gielen, Norman Mangner, Volker Adams, Sandra Erbs, Axel Linke, Rainer Hambrecht, Gerhard C Schuler
Journal: Circulation (2007)

Background: The concept of ventricular-arterial coupling implies that LV-function is determined by the three factors left ventricular diastolic, left ventricular systolic and arterial elastance. We have previously documented an improvement in endothelial function and systolic LV-function in patients with chronic heart failure (CHF) after 6 months of exercise training (ET). It remains, however, unclear, how shorter ET periods may affect endothelial, systolic and diastolic ventricular function as echocardiographic parameters related to ventricular arterial coupling in patients with CHF. METHODS: In this ongoing study we randomised 43 patients with stable CHF (age 60.3 ± 2.9 years, EF 27.4 ± 1.7%, VO 2 max 14.7 ± 4.3ml/kg*min) to a training or a control group (C). Patients in the training group exercised 4 times daily at 70% of the individual heart rate reserve for 4 weeks under supervision. At baseline and after 4 weeks the E/A ratio and septal/lateral E’/A’ velocities were determined by echocardiography with tissue Doppler. Exercise capacity was measured by ergospirometry and flow-mediated dilatation (FMD) was assessed by high-resolution radial ultrasound. RESULTS: After only 4 weeks of ET oxygen uptake at peak exercise increased from 14.9 ± 3.3 to 18.1 ± 4.7 ml/min/kg, (p&lt;0.01 vs. C) in training subjects. Left ventricular ejection fraction improved from 26.8 ± 4.6 to 33.1 ± 5.5% (p&lt;0.05 vs. C) in patients of the training group while it remained unchanged in the control group. E/A-ratio mended from 0.63 ± 0.12 to 0.81 ± 0.22 (p&lt;0.01 vs. C) in training patients. Septal E’ velocities increased from 5.5 ± 0.5 to 7.8 ± 1.4 cm/s in training patients (p&lt;0.05 vs. C). FMD of the radial artery improved from 8.2 ± 2.1 to 15.2 ± 3.8% (p&lt;0.01 vs. C) as a result of ET. CONCLUSIONS: Only 4 weeks of endurance training are highly effective with significantly improved FMD accompanied by an emended systolic and diastolic LV-function. We hypothesise that the improvement in LV-EF in training patients may be caused by a corrected ventricular-arterial coupling: ventricular diastolic relaxation and effective endothelial function are ameliorated resulting in an augmentation of stroke volume.
Uniform Core–Shell Nanoparticles with Thiolated Hyaluronic Acid Coating to Enhance Oral Delivery of Insulin
Authors: Houkuan Tian, Zhiyu He, Chengxin Sun, Chengbiao Yang, Pengfei Zhao, Lixin Liu, Kam W. Leong, Hai‐Quan Mao, Zhijia Liu, Yongming Chen
Journal: Advanced Healthcare Materials (2018)

Oral delivery of protein drugs is an attractive route of administration due to its convenience for repeated dosing and good patient compliance. However, currently oral protein therapeutics show very low bioavailability mainly due to the existence of hostile gastrointestinal (GI) environments, including mucus layers and intestinal epithelial barriers. Herein, using insulin as a model protein therapeutic, the core-shell nanoparticles with thiolated hyaluronic acid (HA-SH) coating (NPHA-SH ) are produced utilizing a two-step flash nanocomplexation process to enhance oral delivery efficiency of insulin. A positively charged nanoparticle core is first generated by electrostatic complexation between insulin and N-(2-hydroxypropyl)-3-trimethyl ammonium chloride modified chitosan (HTCC), followed by surface coating with HA-SH. The optimized NPHA-SH shows an average size of 100 nm with high encapsulation efficiency (91.1%) and loading capacity (38%). In vitro and ex vivo results confirm that NPHA-SH shows high mucus-penetration ability, improved intestinal retention and transepithelial transport property due to its thiolated surface and the ability of HA-SH coating to dissociate from the nanoparticle surface when across the mucosal layer. Oral administration of NPHA-SH to Type 1 diabetic rats yields high efficacy and an average relative bioavailability of 11.3%. These results demonstrate that the HA-SH coated core-shell nanoparticles are a promising oral delivery vehicle for protein therapeutics.
The origin of the recent swine influenza A(H1N1) virus infecting humans
Authors: V Trifonov, H Khiabanian, B Greenbaum, R Rabadan
Journal: Eurosurveillance (2009)

Preliminary analysis of the genome of the new H1N1 influenza A virus responsible for the current pandemic indicates that all genetic segments are related closest to those of common swine influenza viruses.
Abstract 287: Erythropoietin Enables Mitochondria to Preserve Oxidative Phosphorylation Under Conditions of Calcium Overload and Oxidative Stress
Authors: Jeejabai Radhakrishnan, Matthew Ng, Ari Edelheit, Raúl J Gazmuri
Journal: Circulation (2011)

Introduction: We previously reported in rats that a single bolus dose of erythropoietin (Epo) given at the start of CPR enhanced, within minutes, the efficacy of chest compression. The effect was attributed to attenuation of reductions in left ventricular distensibility; an effect previously linked to preservation of mitochondrial bioenergetic function. Hypothesis: We now investigated whether Epo could enable mitochondria to maintain oxidative phosphorylation under conditions of calcium overload and oxidative stress, which are central to injury caused by ischemia and reperfusion. Methods: Mitochondria were isolated from the left ventricle of hearts harvested from groups of rats (n=3) that received during spontaneous circulation no Epo or received Epo (5,000 U/kg) in bolus dose into the right atrium at 60, 240, and 480 seconds before harvest. Separate aliquots of mitochondria were subjected to incremental concentrations of calcium (1.5, 12.5, and 25 µM free calcium) or tert-butyl hydroperoxide (250 and 5000 µM). Phosphate:oxygen (P:O) ratios were then measured in a respiration chamber (MT 200, Mitocell, Strathkelvin Instruments). Results: Epo, in a time dependent manner, prevented reductions in P:O ratios observed when mitochondria were exposed to incremental concentrations of calcium or tert-butyl hydroperoxide (Table). Conclusions: Preservation of left ventricular myocardial distensibility could partly result from a favorable effect of Epo enabling mitochondria to resist injury caused by calcium overload and oxidative stress, and within a response time sufficiently rapid to favorably impact cardiac resuscitation.
THE ENDOSCOPIC TREATMENT OF ZENKER'S DIVERTICULUM: RESULTS OF A COMPARATIVE STUDY
Authors: K Shishin, I Nedoluzhko, I Pavlov, N Kurushkina, L Shumkina
Journal: Endoscopy (2018)

At present day, there are two types of flexible endoscopic treatment of a Zenker's diverticulum: the traditional diverticulo-esophagostomy and the novel tunnel technique. The last one benefits in visually controlled elongation of the myotomy to the first part of the oesophagus. We report the results of a comparative study of the endoscopic treatment of Zenker's diverticulum.
Randomized Trial of Systemic Therapy After Involved-Field Radiotherapy in Patients With Early-Stage Follicular Lymphoma: TROG 99.03
Authors: Michael MacManus, Richard Fisher, Daniel Roos, Peter O’Brien, Andrew Macann, Sidney Davis, Richard Tsang, David Christie, Bev McClure, David Joseph, Jayasingham Jayamohan, John F. Seymour
Journal: Journal of Clinical Oncology (2018)

Follicular lymphoma (FL) is curable by involved-field radiotherapy (IFRT) in < 50% of patients with stage I to II disease. We hypothesized that adding systemic therapy to IFRT would improve long-term progression-free survival (PFS).A multicenter randomized controlled trial enrolled patients with stage I to II low-grade FL after staging computed tomography scans and bone marrow biopsies. 18F-labeled fluorodeoxyglucose-positron emission tomography (PET) was not mandatory. Patients were randomly assigned to either arm A (30 Gy IFRT alone) or arm B (IFRT plus six cycles of cyclophosphamide, vincristine, and prednisolone [CVP]). From 2006, rituximab was added to arm B (R-CVP).Between 2000 and 2012, 150 patients were enrolled, 75 per arm. In arm B, 44 patients were allocated to receive CVP and 31 were allocated to receive R-CVP. At randomization, 75% had stage I, the median age was 57 years, 52% were male, and 48% were PET staged. With a median follow-up of 9.6 years (range, 3.1 to 15.8 years), PFS was superior in arm B (hazard ratio, 0.57; 95% CI, 0.34 to 0.95; P = .033). Ten-year PFS rates were 59% (95% CI, 46% to 74%) and 41% (95% CI, 30% to 57%) for arms B and A, respectively. Patients in arm B who received R-CVP had markedly superior PFS compared with contemporaneous patients in arm A (hazard ratio, 0.26; 95% CI, 0.07 to 0.97; P = .045). Fewer involved regions ( P = .047) and PET staging ( P = .056) were associated with better PFS. Histologic transformation occurred in four and 10 patients in arms B and A, respectively ( P = .1). Ten deaths occurred in arm A versus five in arm B, but overall survival was not significantly different ( P = .40; 87% and 95% at 10 years, respectively).Systemic therapy with R-CVP after IFRT reduced relapse outside radiation fields and significantly improved PFS. IFRT followed by immunochemotherapy is more effective than IFRT in early-stage FL.
Tratamiento de la Enfermedad de Parkinson (EP) mediante PEG-Duodopa®. Experiencia
Authors: G Molina Arriero, C Villar Lucas, N Reyes Campos, D Viso Vidal, R Quiñones Castro, J Espinel Diez, C Riveira Rodriguez, J Aranda Hernández, A Herrera Abián, D Lopez Cuesta
Journal: Endoscopy (2017)

El tratamiento con levodopa es un tratamiento eficaz en la EP pero su uso de forma crónica está relacionado con la aparición de discinesias y fluctuaciones motoras (fenómenos on-off). Estos trastornos motores pueden reducirse si se consigue una concentración constante en plasma, mediante infusión intestinal continua de levodopa-carbidopa (Duodopa®) (Fig. 1).
Patient-Reported Toxicity During Pelvic Intensity-Modulated Radiation Therapy: NRG Oncology–RTOG 1203
Authors: Ann H. Klopp, Anamaria R. Yeung, Snehal Deshmukh, Karen M. Gil, Lari Wenzel, Shannon N. Westin, Kent Gifford, David K. Gaffney, William Small, Spencer Thompson, Desiree E. Doncals, Guilherme H.C. Cantuaria, Brian P. Yaremko, Amy Chang, Vijayananda Kundapur, Dasarahally S. Mohan, Michael L. Haas, Yong Bae Kim, Catherine L. Ferguson, Stephanie L. Pugh, Lisa A. Kachnic, Deborah W. Bruner
Journal: Journal of Clinical Oncology (2018)

Purpose NRG Oncology/RTOG 1203 was designed to compare patient-reported acute toxicity and health-related quality of life during treatment with standard pelvic radiation or intensity-modulated radiation therapy (IMRT) in women with cervical and endometrial cancer. Methods Patients were randomly assigned to standard four-field radiation therapy (RT) or IMRT radiation treatment. The primary end point was change in patient-reported acute GI toxicity from baseline to the end of RT, measured with the bowel domain of the Expanded Prostate Cancer Index Composite (EPIC). Secondary end points included change in patient-reported urinary toxicity, change in GI toxicity measured with the Patient-Reported Outcome Common Terminology Criteria for Adverse Events, and quality of life measured with the Trial Outcome Index. Results From 2012 to 2015, 289 patients were enrolled, of whom 278 were eligible. Between baseline and end of RT, the mean EPIC bowel score declined 23.6 points in the standard RT group and 18.6 points in the IMRT group ( P = .048), the mean EPIC urinary score declined 10.4 points in the standard RT group and 5.6 points in the IMRT group ( P = .03), and the mean Trial Outcome Index score declined 12.8 points in the standard RT group and 8.8 points in the IMRT group ( P = .06). At the end of RT, 51.9% of women who received standard RT and 33.7% who received IMRT reported frequent or almost constant diarrhea ( P = .01), and more patients who received standard RT were taking antidiarrheal medications four or more times daily (20.4% v 7.8%; P = .04). Conclusion Pelvic IMRT was associated with significantly less GI and urinary toxicity than standard RT from the patient’s perspective.
Eficacia de la aplicación endoscópica de una plataforma bioactiva liberadora de infliximab en un modelo de colitis experimental en ratas
Authors: V Lorenzo-Zúñiga García, J Boix, V Moreno de Vega, I Bon, I Marín, N Caballero, R Bartolí
Journal: Endoscopy (2017)

Las lesiones mucosas refractarias en pacientes con EII son un reto clínico importante. Las terapias biológicas han cambiado la forma de tratar a estos pacientes. La administración endoscópica de estos fármacos (terapia dirigida) podría disminuir esta inflamación activa refractaria proporcionando beneficios clínicos importantes. Hemos desarrollado un nuevo hidrogel (TriBio) con triple actividad biológica (bioadhesiva, biocompatible y bioactiva) que puede actuar como plataforma bioactiva liberadora fármacos. El objetivo de este estudio fue evaluar la utilidad de la administración endoscópica de la plataforma TriBio con infliximab (IFX 0,5 mg/mL) en un modelo de colitis experimental en ratas.
OPHTHALMIC SYMPTOMS AND COLORECTAL CANCER
Authors: J Espinel, M Eugenia Pinedo
Journal: Endoscopy (2018)

Venous drainage of the colon is done through the portal system. The first place of hematogenous spread of colorectal cancer (CRC) is usually the liver, followed by lung and bone. Another less frequent site is the brain (0.06 – 3.2%). The ocular metastases of CRC have been described in exceptional cases and, even less, as an initial manifestation of CRC.
Alzheimer Disease
Authors: Jill Jin
Journal: JAMA (2015)

Alzheimer disease is a common cause of dementia in older adults. Causes of Alzheimer DiseaseDevelopment of Alzheimer disease is related to 2 abnormal proteins in the brain called β-amyloid and tau, which are toxic to nerve cells (neurons) in the brain.The buildup of these proteins in neurons eventually leads to neuron death, worsened brain function, and symptoms of dementia.Dementia is a term used to describe a decline in mental abilities including memory, language, and logical thinking.The exact trigger for Alzheimer disease is unknown.It tends to run in families, meaning there is a genetic component.More than 30 genes have been identified that may be involved in Alzheimer disease.Three genes have been found to be passed down from parent to child in a "dominant" manner, with about half of children of an affected parent also eventually developing Alzheimer disease.Alzheimer disease symptoms usually occur after age 65 years, but often, the types of Alzheimer disease that run in families occur earlier.
Apolipoprotein B binds to enolase-1 and aggravates inflammation in rheumatoid arthritis
Authors: Joo Youn Lee, Min Jueng Kang, Ji Yong Choi, Ji Soo Park, Jin Kyun Park, Eun Young Lee, Eun Bong Lee, Thomas Pap, Eugene C Yi, Yeong Wook Song
Journal: Annals of the Rheumatic Diseases (2018)

Objective Immune cells from patients with rheumatoid arthritis (RA) express more enolase-1 (ENO1) on their surface than those from healthy subjects, and they elicit an enhanced inflammatory response. This study is aimed to identify the ligands of ENO1 that could promote inflammatory loops in vitro and enhance the arthritis severity in vivo. Methods ENO1-binding proteins in RA synovial fluid were identified by mass spectromety, and affinity to ENO1 was evaluated by means of a ligand blotting and binding assay, surface plasmon resonance and confocal microscopy. Proinflammatory response by the interaction between ENO1 and apolipoprotein B (apoB) was tested in vitro and in vivo using peripheral blood mononuclear cells and a K/BxN serum transfer arthritis model and low-density lipoproteins receptor (LDLR) knockout mice. Results ApoB in the synovid fluid of patients with RA was identified as a specific ligand to ENO1 with a higher affinity than plasminogen, a known ENO1 ligand. ApoB binding to ENO1 on monocytes elicited the production of tumour necrosis factor-α, interleukins (IL)-1β and IL-6 through both p38 mitogen-activated protein kinase and NF-κB pathways. In the K/BxN serum transfer arthritis model, administration of apoB increased the production of proinflammatory cytokines and exaggerated arthritis severity. The severity of K/BxN serum transfer arthritis in LDLR knockout mice was comparable with wild-type mice. Conclusions A key component of atherogenic lipids, apoB, aggravated arthritis by potentiating the inflammatory response via its interaction with ENO1 expressed on the surface of immune cells. This suggests a novel mechanism by which lipid metabolism regulates chronic inflammation in RA.
The Addiction Solution: Treating Our Dependence on Opioids and Other Drugsby Lloyd I. Sederer, M.D. New York, Simon &amp; Schuster, 2018, 224 pp., $26.00 (hardcover).
Authors: Andrew J. Saxon
Journal: American Journal of Psychiatry (2018)

unipolar nonpsychotic depression in a variety of demographic populations, at various ages, and in assorted life situations.Initial results of a large, carefully conducted randomized controlled trial funded by the National Institute of Mental Health and led by John Markowitz at Columbia University showed that, compared with prolonged exposure therapy, IPT produced roughly equivalent results as prolonged exposure therapy for patients with chronic PTSD (2).On average, these patients were 40 years old, had experienced their primary trauma 14 years previously, and were mostly chronically interpersonally traumatized; half had comorbid major depression, and nearly half had personality disorders, representing garden-variety patients seen in mental health care settings.Overall, the patients preferred IPT, which also produced fewer dropouts and achieved greater response rates for patients with comorbid depression.This work suggested that IPT might merit a seat at the table when treatment strategies for PTSD are under consideration.Based on these results, Markowitz, for several decades one of our leading IPT researchers, scholars, and advocates, now offers us a highly informative and useful treatment manual demonstrating IPT's application for PTSD.Here, IPT is adapted to address several PTSD-specific issues.Therapists address affective reattunement (helping patients identify and face their emotions), focus on the interpersonal aftereffects of trauma, encourage patients to mobilize social supports, and focus on other interpersonal macro and micro issues pertinent to the trauma, all while embracing the transtheoretical common factors of effective psychotherapies.Chapter after chapter details these processes with rich clinical examples and session-by-session verbatim script extracts.The book includes prescriptions of useful things to do and not to do, training discussions, patient handouts, and discussion of next steps, including efforts to understand parallel healing processes between IPT and exposure-based treatments.Ultimately, fruitful considerations would also address determining which aspects of which therapies together with which medications would be most useful for which patients at which particular times during their course.Given how frequently practitioners treat patients with PTSD and considering IPT's practical and humane approach, the respectable clinical response rates demonstrated here, and its high patient acceptance, I'd advise a wide range of clinicians to acquaint themselves with IPT's application for these conditions.Showing the hand of a thoughtful, experienced, wise clinician and scholar, this well-written volume is an excellent place to start.
Limpieza de colon en pacientes ingresados: Estudio comparativo de dos tipos de preparación
Authors: M Ibáñez García, L Mata Román, A Miguel, A San José, I Aguado, I Alonso, R Díez González
Journal: Endoscopy (2017)

Los pacientes ingresados son un grupo de especial dificultad para la preparación de colon, debido a que con mayor frecuencia presentan: mala situación clínica (>ASA 3), toma de fármacos (antidepresivos, antagonistas del calcio y opioides), falta de movilidad, comorbilidad asociada (demencia, depresión, IRC) y algunas patologías colónicas como la diverticulosis y colectomía previa.
Pazopanib plus cetuximab in recurrent or metastatic head and neck squamous cell carcinoma: an open-label, phase 1b and expansion study
Authors: Douglas Adkins, Paul Mehan, Jessica Ley, Marilyn J Siegel, Barry A Siegel, Farrokh Dehdashti, Xuntian Jiang, Noha N Salama, Kathryn Trinkaus, Peter Oppelt
Journal: The Lancet Oncology (2018)
Colangitis aguda recurrente: Estado actual del problema
Authors: ME Lauret Braña, E Rubio Díaz, R García Castro, M Rodríguez Peláez, V Álvarez García, A Suárez González
Journal: Endoscopy (2017)

La colangitis aguda (CA) es una de las principales indicaciones de la colangiopancreatografía retrógrada endoscópica (CPRE). Su recurrencia condiciona repetidos ingresos hospitalarios y procedimientos endoscópicos de drenaje.
Abstract 4944: Bayesian Analysis of TRITON-TIMI 38: Reassessing Prasugrel versus Clopidogrel in the Treatment of Patients With Acute Coronary Syndrome
Authors: Christopher Lang, Rohit Arora
Journal: Circulation (2009)

Background: The application of Bayesian analytic techniques can provide clinically relevant information regarding efficacy of an intervention. Given the recent controversy surrounding prasgurel, as reported in the TRITON-TIMI 38 study, we sought to re-examine both the frequentist and Bayesian statistical methods which evaluated this study. Methods: Magnitude of therapeutic benefit and a sensitivity analysis were performed, using posterior probabilities (Pr), in relation to probability of benefit versus harm, as well as probabilities of greater than 20% benefit (Pr&gt;20%). The analysis was conducted with experiential probabilities obtained from the TRITON-TIMI 38 data, and a null prior probability with a log mean OR of 0, and a standard deviation of 2. Results: Based on the study results, the Pr for the primary endpoint of death from cardiovascular causes, nonfatal MI, or nonfatal stroke is 99.9%. Calculated probability of at least a 20% benefit is 66.5%. This value is reasonably high enough to infer a clinically important benefit. All cause mortality was also found to have a clinically relevant benefit at Pr&gt;20% of 99.1%. Analysis does indicate a clinically significant probability of harm pertaining to Non-CABG major and major plus minor bleeding, with a probability of at least 20% harm of 73.6 and 82.4% respectively. Conclusions: On re-evaluation, the Bayesian analysis suggests the clinical relevance of prasugrel as a beneficial treatment in patients with ACS, which serves to support the implications of the conventional statistics reported in TRITON-TIMI 38. Of note, the clinically relevant benefit is juxtaposed against the harm related to bleeding complications.
Cabin fever
Authors: Alison Tonks
Journal: BMJ (2008)

Occasionally people are born, become ill, and even die on board aircraft in flight. In July last year, Paul Keetch, Liberal Democrat member of parliament for Hereford, collapsed on a flight from London to Washington, DC. He survived a potentially lethal arrhythmia after prompt treatment with an automatic external defibrillator. Earlier this year a pilot for Air Canada developed signs of acute mental illness near the end of a transatlantic flight and had to be escorted off the rapidly diverted plane into a mental health facility in Ireland.1 Less than a month later, copilot Michael Warren collapsed and died on a flight to Cyprus. The plane landed safely in Istanbul.2

When the worst happens, the captain often asks for help from medical professionals who happen to be on board. Doctors who answer the call must practise medicine in one of the remotest environments on earth. But here are some reassuring thoughts: despite these headline events, of the 36 million passengers carried by British Airways last year, only 375 needed a doctor while flying; and if you do offer to help a stricken passenger or crew member you will be acting as part of a team with shared responsibility for what happens. Industry experts say the risk of litigation is close to zero.