tbuckley/cabot-search huggingface dataset:
Combined tumor necrosis factor-α (TNF–α) and interleukin-2 (IL-2) blockade in acute steroid refractory graft-versus-host disease (SR-GVHD) following allogeneic hematopoietic stem cell transplantation (HCT)
Authors: M. Ramanathan, R. Srinivasan, N. Geller, T. Donohue, R. Goodwin, L. Cook, C. Ramos, J. Barrett, R. Childs
Journal: Journal of Clinical Oncology (2009)

7023 Background: SR-GVHD is a frequent and often fatal complication of HCT. A variety of inflammatory cytokines have been implicated in the pathogenesis of GVHD; single agent therapy against targets such as the IL-2 receptor α chain (daclizumab) or TNF-α (infliximab) has modest activity in SR-GVHD. We hypothesized that concomitant blockade of both TNF-α and IL-2 pathways would be more effective in controlling SR-GVHD than inhibition of either cytokine alone. Methods: The incidence of and outcome following SR-GVHD in 141 pts undergoing nonmyeloablative HCT from an HLA-matched family donor at our institution between February 2001 and November 2008 were analyzed. All SR-GVHD pts were treated with a combination of daclizumab (1 mg/kg, days1, 4, 8, 15, 22) and infliximab (10 mg/kg, days1, 8, 15, 22); in addition, aspergillus prophylaxis, empiric broad-spectrum antibiotics, and a rapid reduction in the dose of corticosteroids was initiated in order to minimize the risk of opportunistic infections associated with immunosuppression. Results: Twenty-three pts (23/141, 16%) developed SR-GVHD (median age 35 y, range 17–65 y); involved organs included the GI tract (n = 23), liver (n = 3), and skin (n = 8). We observed a remarkably high response rate following therapy, with 20/23 (87%) pts experiencing complete resolution of GVHD. Responses were usually delayed (median onset 2 weeks) but durable. The most notable complication associated with therapy was the development of opportunistic infections (invasive fungal infections in 3 pts); in 2/3 of these cases, prophylactic antifungal therapy had been discontinued prematurely due to drug toxicity. The median survival for the SR-GVHD cohort was 255 days (range 67–2,148 days), with 10/23 pts surviving at the time of this analysis. Causes of death included underlying cancer (5 pts), CMV disease (2 pts), and infectious complications (5 pts). Conclusions: These data suggest combined TNF-α /IL-2 blockade is a highly effective therapeutic option for pts with SR-GVHD and highlight the need for aggressive antimicrobial prophylaxis in the management of this condition. No significant financial relationships to disclose.
Foreign Bodies in the Rectum: A Review
Authors: Philip F Schofield
Journal: Journal of the Royal Society of Medicine (1980)

Foreign bodies which lodge above the anal sphincter mechanism may arrive from one of two portals of entry, the mouth or the anal canal. Ingestion of a foreign body is usually unknown to the patient, who presents with symptoms due to impaction and minor injury to the rectal ampulla or anal canal. The patient may have severe anal pain or sepsis associated with the foreign body. The diagnosis is usually obvious on examination under an anaesthetic, but before this there may be a difficult diagnostic problem. Foreign bodies passed into the rectum through the anal sphincter are more common and show an extreme variety. The reasons for insertion are discussed. Management of the problem includes extraction of the foreign body and the recognition and treatment of any associated injury, both extraperitoneal and intraperitoneal. Minor extraperitoneal injuries may be treated expectantly, but in all intraperitoneal and major extraperitoneal injuries laparotomy and colostomy are required. It is stressed that most foreign bodies can be removed transanally, and laparotomy to remove the foreign body is rarely required.
Clinicians' guidelines for assessing and presenting subtle forms of patient incompetence in legal settings
Authors: Thomas G. Gutheil, Harold Bursztajn
Journal: American Journal of Psychiatry (1986)

Even for nonforensic clinicians, the assessment of the patient's competence has grown in importance, particularly regarding the issues of informed consent and right to treatment. However, the incompetence of patients with paranoid states, depression, mania, and anorexia nervosa may be so subtle that both assessors and the court are deceived, incompetence is not recognized, and treatment is stalemated. The authors provide guidelines designed to equip the clinician to assess--and to present in an effective manner in court--the clinical findings relevant to incompetence, to the benefit of both the patient's rights and treatment.
Abstract 6188: Wide Pulse Pressure as a Predictor of Poor Outcome after Renal Angioplasty and Stenting
Authors: Amir Darki, Ali Morshedi-Meibodi, Ghazanfar Khadim, Vikramjit S Chhokar, Lowell Steen, Bruce E Lewis, Fred Leya, Robert S Dieter
Journal: Circulation (2008)
Abstract 10852: Temporal Trends in Pulse Pressure for U.S. Children During the Rise of Obesity
Authors: Justin P Zachariah, Dionne Graham, Sarah D deFerranti, Ramachandran S Vasan, Jane W Newburger, Gary F Mitchell
Journal: Circulation (2011)

Background: Excess weight increases cardiovascular disease (CVD) risk in part by impairing aortic function. Pulse pressure (PP), a measure of aortic function, predicts hypertension and CVD events. ...
Abstract 27: Pathological Findings Of Ventricular Fibrillation In Pts Without Coronary Heart Disease
Authors: Rinya Kato, Takahiro Okumura, Yoshimi Kitagawa, Tatsunari Satake
Journal: Circulation (2007)

To clarify histological characteristics in pts (pts) with out-of-hospital cardiac arrest , autopsies were immediately performed in 224 pts. We studied the cause of their sudden death investigating ...
Atlas of Tumor Pathology By 38 or more authors, in 24 volumes (40 fascicles). Published under the Auspices of the Subcommittee on Oncology, Committee on Pathology, National Research council, by The Armed Forces Institute of Pathology, American Registry of Pathology, 7th and Independence Avenue, Washington 25, D.C.
Authors: Dale Rex Coman
Journal: Cancer Research (1953)
Angiographic Stent Thrombosis After Routine Use of Drug-Eluting Stents in ST-Segment Elevation Myocardial Infarction
Authors: Georgios Sianos, Michail I. Papafaklis, Joost Daemen, Sofia Vaina, Carlos A. van Mieghem, Ron T. van Domburg, Lampros K. Michalis, Patrick W. Serruys
Journal: Journal of the American College of Cardiology (2007)
The Structured Clinical Interview for DSM-III-R Dissociative Disorders: preliminary report on a new diagnostic instrument
Authors: M Steinberg, B Rounsaville, D V Cicchetti
Journal: American Journal of Psychiatry (1990)

The authors describe the Structured Clinical Interview for DSM-III-R Dissociative Disorders (SCID-D), which investigates five groups of dissociative symptoms (amnesia, depersonalization, derealization, identity confusion, and identity alteration) and systematically rates both the severity of individual symptoms and the evaluation of overall diagnosis of dissociative disorder. Preliminary findings from a study of 48 subjects with and without psychiatric diagnoses indicate good to excellent reliability and discriminant validity for the SCID-D as a diagnostic instrument for the five dissociative disorders and as a tool for the evaluation of dissociative symptoms encountered within nondissociative syndromes.
Abstract 16342: Cardiac Specific Heat Shock Protein B2 (HSPB2) Exerts Paradoxical Cardioprotection Against Pressure Overload and Ischemic/Reperfusion in Mice
Authors: Takahiro Ishiwata, Andras Orosz, Xiaohui Wang, Lensey Scott, Soumyajit Mustafi, Greg Pratt, Elisabeth Christians, Sihem Boudina, Dale Abel, Ivor Benjamin
Journal: Circulation (2011)

Backgrounds and Objectives Small Heat Shock Proteins (HSPs) display chaperone-like activities and protect cells against apoptosis and ischemia/reperfusion (I/R) injury. HSPB2 is expressed at high l...
Deciphering the role of tau in neurodegeneration using Adeno-Associated Viral (AAV) vectors to express human tau in the mouse forebrain
Authors: Aurélien Lathuilière, Stéphanie Papin, Matthias Cacquevel, Paolo Paganetti, Andreas Muhs, Graham Knott, Bernard Schneider, Patrick Aebischer
Journal: Molecular Neurodegeneration (2013)

Background Tau related pathology is the most reliable predictor of cognitive decline in Alzheimer’s disease. However, it remains unclear by which mechanisms tau contributes to neurodegeneration and neuronal dysfunction. The use of viral vectors provides an effective approach to replicate cardinal features of tauopathies in the mouse brain. AAV vectors were designed for overexpression of various forms of human tau, in order to dissect the mechanisms underlying tau hyperphosphorylation, aggregation and neurotoxicity in vivo.
Abstract 2146: Significant Electrocardiographic Predictors of Cardiovascular Mortality in Patients with Left Bundle Branch Block
Authors: Amir Kaykha, Kenneth Desser, Nathan Laufer, Timothy Byrne, Ashish Pershad, Jonathan Myers, Victor Froelicher
Journal: Circulation (2008)

Although QRS prolongation has been reported to be a significant predictor of mortality in patients with left bundle branch block (LBBB), the prognostic value of other ECG criteria in patients with ...
Abstract 1148: Local Hypercoagulability and Endothelial Dysfunction after Sirolimus-Eluting Stent Implantation: Implication for Late Stent Thrombosis
Authors: Koji Yamaguchi, Tetsuzo Wakatsuki, Toshiyuki Niki, Kenya Kusunose, Kunihiko Koshiba, Syusuke Yagi, Takashi Iwase, Hirotsugu Yamada, Takeshi Soeki, Masashi Akaike, Masataka Sata
Journal: Circulation (2008)

Endothelial dysfunction is known to cause hypercoagulability. The long-term effects of sirolimus-eluting stent (SES) on endothelial function are not known. We evaluated endothelial function and local hypercoagulability more than six months following SES or bare metal stent (BMS) implantation. Forty-three patients treated six months earlier with a coronary stenting for isolated proximal left anterior descending (LAD) stenosis, with no evidence of restenosis, were studied. Sixteen patients had been stented with BMS, and 27 had been with SES. Changes in diameter at distal site of the stented LAD in response to intracoronary acetylcholine infusions (30μg/min) were assessed by quantitative angiography. We also measured plasma levels of prothrombin fragment F1+2 (F1+2) and D-dimer sampled in coronary sinus (CS) and sinus of Valsalva (V). The mean percent change in the diameter of the stented LAD was significantly more in the SES group than in the BMS group (−33.4±5.9 vs. −19.8±6.0%, p&lt;0.05). The translesional F1+2 gradient [F1+2(CS) minus F1+2(V)] and D-dimer gradient were greater in the SES group than in the BMS group (0.52±0.68 vs. −0.10±0.29 nmol/l, p&lt;0.05 and 0.22 ±0.38 vs. −0.12±0.35 μg/ml, p&lt;0.05, respectively). An increased local coagulative response and more severe endothelial dysfunction were observed long term after SES implantation as compared to BMS. In the SES group, delay of endothelial regrowth might be associated with our findings.
Abstract 1254: Development of a Risk Score for Incident Atrial Fibrillation in the Community; the Framingham Heart Study
Authors: Renate B Schnabel, Lisa M Sullivan, Daniel Levy, Michael J Pencina, Joseph M Massaro, Ralph B D’Agostino, Christopher Newton-Cheh, Jared W Magnani, Thomas M Tadros, William B Kannel, Thomas J Wang, Patrick T Ellinor, Philip A Wolf, Ramachandran S Vasan, Emelia J Benjamin
Journal: Circulation (2008)

Atrial fibrillation (AF) contributes to increased morbidity and mortality. An easily applicable AF risk score for incidence of AF in the community is unavailable. We examined 8044 person-exams among subjects who were 46 –95 years of age and attended routine Framingham Heart Study (FHS) exams (n=4764 individuals; mean age 61 years, 55% women). Multivariable Cox regression related clinical data to 10-year AF incidence (n=457). Secondary analyses incorporated routine echo data (n=7156, 445 events) for left atrial size, left ventricular wall thickness, and fractional shortening. Age, sex, body mass index, significant murmur, systolic blood pressure, hypertension treatment, PR interval, and heart failure were associated with incident AF (C-statistic 0.78; 95% CI 0.76 – 0.80; p&lt;0.05). Predicted 10-year risks of AF were similar to observed risks (calibration Chi 2 statistic=4.16; p=0.90). In a later FHS sample, additional incorporation of echo variables slightly increased the C-statistic from 0.78 (0.75– 0.80) to 0.79 (95% CI 0.77– 0.82), p=0.005. Reclassification by echo variables was only modest (integrated discrimination improvement of 0.021; p=0.003). We provide a point score (and excel spreadsheet) for incident AF. The figure displays AF risk by selected risk factor levels. The FHS AF risk profile stratifies individuals in the community, and may provide a framework to evaluate new biological or genetic markers for AF risk prediction. Further studies are needed to validate the risk score in other populations. Predicted 10-Year Risk of AF by Risk Factors &amp; Sex
Time for a hospital antacid policy on <i>Clostridium difficile</i>
Authors: Jecko Thachil
Journal: BMJ (2008)

Forgacs and Loganayagam mention the increasing risk of Clostridium difficile infection with use of proton pump inhibitors (PPIs) in hospitals.1 The ability of the vegetative form of C difficile to survive in gastric contents with a raised pH caused by excess use of PPI has been proposed as a potential mechanism. …
Abstract 14285: Predictors of Reverse Remodeling Failure and Survival Following Mitral Valve Repair
Authors: Leonidas V Athanasopoulos, James D Rawn, Siobhan McGurk, Jan D Schmitto, Zain Khalpey, Laurens Wollersheim, Ann M Maloney, Nicole Kelly, Lawrence H Cohn
Journal: Circulation (2011)

Objectives: To elicit predictors of reverse heart remodeling following mitral valve repair. Methods: We retrospectively identified 494 patients (pts) with preop/postop echocardiographic data. Norma...
National Seasonal Influenza Vaccination Survey in Europe, 2008
Authors: J Mereckiene, S Cotter, A Nicoll, D Lévy-Bruhl, A Ferro, G Tridente, G Zanoni, P Berra, S Salmaso, D O'Flanagan, D O’Flanagan, Collective on behalf of the VENICE 2 project gatekeepers group
Journal: Eurosurveillance (2008)

A cross-sectional survey was undertaken with the European Union (EU) Member States and Norway and Iceland to describe seasonal influenza immunisation in the 2006-7 season, in particular to identify country-specific recommendations for risk groups, obtain vaccine uptake information and allow comparison with global recommendations. A standardised questionnaire was completed electronically by each country's project gatekeeper. Of the 29 countries surveyed, 28 recommended seasonal influenza vaccination for older age groups (22 for those aged > 65 years), and in one country vaccine was recommended for all age groups. All countries recommended vaccinating patients with chronic pulmonary and cardiovascular diseases and most countries advised to immunise patients with haematologic or metabolic disorders (n=28), immunologic disorders (n=27) and renal disease (n=27), as well as residents of long-term care facilities (n=24). Most countries recommended vaccination for staff in hospitals (n=25), long-term care facilities (n=25) and outpatient clinics (n=23), and one-third had such recommendations for workers in essential (n=10), military (n=10) and veterinary services (n=10) and poultry industry (n=13). Eight countries recommended vaccine for pregnant women; and five advised to vaccinate children (with age limits ranging from 6 months to 5 years). Twenty countries measured influenza vaccine uptake among those aged > 65 years (range 1.8%-82.1%), seven reported uptake in healthcare workers (range 14%-48%) and seven assessed coverage in persons with underlying medical conditions (range 27.6%-75.2%). The data provided by this study can assist EU states to assess and compare their influenza vaccination programme performance with other countries. The information provides a comprehensive overview of policies and programmes and their outcomes and can be used to inform joint discussions on how the national policies in the EU might be standardised in the future to achieve optimal coverage. Annual surveys could be used to monitor changes in these national policies.
TV: Horizon: Living with ADHD
Authors: Charles Essex
Journal: BMJ (2005)

When I see a child with a disability or behaviour problem I know that I see them for 30 minutes and then move on to the next patient. The parents cannot move on. This programme showed some of what parents of children with attention-deficit hyperactivity disorder (ADHD) have to put up with.

As cameras followed two families for six months the parents told their experiences without interruption from an interviewer. The viewer saw some of the day to day behaviour of children with ADHD and the parents' feelings of frustration, impotence, anger, and guilt. There was sensible information about what ADHD is; co-morbidities such as dyslexia and oppositional defiant disorder; the genetics and neurobiology of ADHD; and methylphenidate, which for once was not demonised as a chemical cosh. It would have been helpful to see the children's behaviour in school.

Liam was a runner and a climber. He clearly had ADHD and oppositional defiant behaviour. Initially it was tempting to wonder which came first—his defiant behaviour or his parents' frequent (ineffective) efforts telling him to behave.

One could see why parents of children like this smack them or worse. Liam's mother admitted to being at the end of her tether and clearly felt guilty that she disliked her child. She admitted that if she disliked an adult that much she would have nothing to do with them. But she also recognised Liam's good qualities.​qualities.




Figure 1



Liam: a runner and a climber

Credit: BBC




Liam's behaviour at home, in a multistorey car park, and when shopping was a good picture of a child with ADHD. When the local ADHD assessment team gave the diagnosis, the parents were relieved. They found strength in that and opted for the moment not to give Liam medication. They have been offered special behaviour classes.

James and Jasmine were two siblings with ADHD. Their mother, who was doing a grand job as a single parent, realised she had had ADHD as a child and still had it. All three of them were on methylphenidate. On Jasmine's first day at secondary school the household was in chaos and mum forgot to give everyone their methylphenidate. We saw the deterioration in behaviour when a dose was missed. A psychologist worked with the mother on behaviour management—tokens and rewards for the children; and a timetable and structure to the mother's day, all of which seemed to help.

The shortage of child psychiatrists in the United Kingdom will not be resolved in the next decade, so most ADHD will continue to be diagnosed and treated by community paediatricians, often without the ideal package of behaviour support as well. I will use some parts of the video of this programme to give trainees an insight into ADHD outside the clinic.
Abstract 17038: Long-Acting Phosphodiesterase-5 Inhibitor Tadalafil Attenuates Oxidative Stress and Protects Against Myocardial Ischemia/Reperfusion Injury in Type 2 Diabetic Mice
Authors: Saisudha Koka, Anindita Das, Fadi N Salloum, Rakesh C Kukreja
Journal: Circulation (2011)

Background: Diabetic patients exhibit increased risk for the development of cardiovascular diseases. Recent findings from our laboratory suggest that phosphodiesterase-5 (PDE-5) inhibitor, sildenafil, restores NO signaling and protects against ischemia/reperfusion injury. In this study, we determined the effect of long-acting PDE-5 inhibitor, tadalafil (TAD), on type 2 diabetes associated complications in db/db mice. Methods and Results: Adult male db/db mice (n=24/group) were randomized to receive: DMSO (10%, 0.2 ml, i.p.) or TAD (1 mg/kg, i.p) for 28 days. The mice were sacrificed and blood was collected for assessment of biochemical parameters. Cardiomyocytes were isolated from the hearts and subjected to 40 min simulated ischemia followed by 1 h of reoxygenation. Dichlorodihydrofluorescein diacetate and JC-1 staining were used to measure ROS generation and mitochondrial membrane potential (Δψm), respectively. A second subset of mice hearts were subjected to 30 min global ischemia followed by 60 min reperfusion in Langendorff mode. Infarct size was measured using computer morphometry of tetrazolium stained sections. A third subset of mice hearts were used for the estimation of lipid peroxidation, GSSH/GSH and the expression of myocardial pAKT and pAMPK by Western blot. TAD treatment reduced the body weight (48.5±1.5 g vs 51.9±1.3 g), fasting plasma glucose levels (466.1±41.4 mg/dl vs 567.7±29.7 mg/dl), insulin (2.97±0.67 ng/ml vs 14.42±3.15 ng/ml; p&lt;0.02) and triglycerides (91.2±12.3 mg/dl vs 190.5±38.5 mg/dl; p&lt;0.05) as compared to control db/db mice. TAD-treated mice also showed reduced infarct size compared to the control db/db mice (21.2±1.8% vs 45.8±2.8%; p&lt;0.01). Control db/db mice demonstrated enhanced oxidative stress as indicated by significantly increased ROS production, lipid peroxidation and GSSH/GSH ratio which were attenuated in TAD-treated mice. Furthermore, TAD treatment preserved the loss of Δψm and enhanced the expression of myocardial pAKT and pAMPK compared to the control (n=4/group; p&lt;0.05). Conclusion: Chronic treatment with TAD attenuates oxidative stress and improves mitochondrial integrity while providing powerful cardioprotective effects through Akt-AMPK signaling in type 2 diabetes.
Abstract 16159: The Association of Psychosocial Factors to Self-Reported Functional Health Status in a Large Cohort of Young Adults With Repaired Transposition of the Great Arteries: A Multi-Institutional Congenital Heart Surgeons' Society Study
Authors: Anusha Jegatheeswaran, Karl F Welke, Eugene H Blackstone, Paul M Kirshbom, Linda M Lambert, Stephanie Fuller, Christo I Tchervenkov, Ronald K Woods, Kathleen A Mussatto, Timothy B Cotts, James D St. Louis, Jeffrey P Jacobs, Marshall L Jacobs, Christopher A Caldarone, William G Williams, Brian W McCrindle
Journal: Circulation (2011)
Aberrant semantic activation in schizophrenia: a neurophysiological study
Authors: P G Nestor, M O Kimble, B F O'Donnell, L Smith, M Niznikiewicz, M E Shenton, R W McCarley
Journal: American Journal of Psychiatry (1997)

Schizophrenia has long been thought to be characterized by a fundamental disturbance in semantic associations, which has often been presumed to be of neurobiological origin. The authors examined the neurophysiological characteristics of semantic processing in schizophrenic patients.During EEG recording, 15 schizophrenic patients and 15 age-matched comparison subjects read sentences that had either sensible or nonsensical endings. The authors recorded the N400 component, a specific negative event-related brain potential occurring approximately 400 msec after the final word in the sentence. N400 is highly, if not uniquely, sensitive to semantic expectancy and context, and larger, more negative N400 amplitude is associated with increased semantic unexpectancy.In relation to the normal comparison subjects, the schizophrenic patients demonstrated prolonged N400 latency after nonsensical sentence endings and also showed enhanced N400 negativity, regardless of the sense of the sentence ending.These findings suggest slower and more diffuse semantic activation in patients with schizophrenia, perhaps reflective of a disease-related failure to maintain and to use semantic context.