tbuckley/cabot-search huggingface dataset:
Pilot study of intense pulsed light for the treatment of systemic sclerosis-related telangiectases
Authors: A.K. Murray, T.L. Moore, H. Richards, H. Ennis, C.E.M. Griffiths, A.L. Herrick
Journal: British Journal of Dermatology (2012)

Telangiectases represent microvascular changes inherent in the systemic sclerosis (SSc) disease process. Intense pulsed light (IPL) is an effective treatment for non-SSc-related cutaneous telangiectases.This pilot study aimed to examine the efficacy, safety and tolerability of IPL treatment in an open study of patients with SSc.Patients underwent three treatments of IPL at monthly intervals and attended follow-up examinations at 1, 6 and 12 months after final treatment. Photographs, laser Doppler imaging (LDI) and thermography were used to measure changes at each visit.Seventeen patients completed the study. Photographs were graded (compared with baseline) as: at 1-month follow-up, four 'no change', four 'improved' and eight 'much improved'; at 6-month follow-up, four 'no change', eight 'improved'; and four 'much improved'; and at 12-month follow-up (eight images were available), three 'no change', two 'improved' and three 'much improved'. Perfusion as measured by LDI (perfusion units) was significantly reduced, compared with baseline [median 2·66, interquartile range (1·78-3·93)], at 1 month [1·70 (1·07-2·55), P = 0·006] and 6 months [2·05 (1·42-2·36), P = 0·008] post-treatment, but not at 12 months [1·61 (1·14-3·22), P =0·088]. No differences were found in skin temperature between baseline and follow-up visits.In this pilot study (the first of IPL treatment for SSc-related telangiectases) most patients improved after IPL treatment. However, the degree of improvement was not maintained in all patients at 6-12 months, suggesting that further treatments may be necessary. Longer term studies of this novel treatment approach are now required.
Cesarean Delivery and Risk of Herpes Simplex Virus Infection—Reply
Authors: Dwight J. Rouse, Jeffrey S. A. Stringer
Journal: JAMA (2003)

To the Editor: Based on 18 cases of neonatal herpes, Dr Brown and colleagues argue that “development of a strategy to reduce this disease burden seems imperative.” What, though, is the actual disease burden? The authors provided no clinical outcome details about the neonatal herpes cases they observed and did not acknowledge that theirs is among the highest incidence ever to be reported. Before broad neonatal herpes preventive efforts (eg, serologic screening) are instituted, the incidence and severity of neonatal herpes should be better defined and categorized on a populationwide basis. In California, during the 10-year period of 1985-1995, the incidence of neonatal herpes was stable at 1.1 per 10000 births, a rate 3 times lower than that reported by Brown et al. It is difficult to imagine that screening and treatment for such an uncommon disease would ever be efficient or cost-effective.
The London bombings: a hospital doctor's experience
Authors: Alexander Wai Ying Chen
Journal: BMJ (2005)

I work as a cardiology registrar at University College London Hospital. On Thursday 7 July 2005 I started a ward round at 8 am. Towards the end of this round we were interrupted by an announcement that the hospital had just gone on to major incident alert, as “four bombs had gone off and multiple casualties were expected.” Our reaction to this news was initially shock and disbelief, but as soon as the staff realised the enormity of what had happened they all did everything they could to help.

Senior medical staff quickly and proficiently assessed every patient on the medical wards, and all stable patients were taken to our sister hospital, the Middlesex. Porters and nurses worked together, helping patients from beds to wheelchairs; and ambulances transferred patients across to the other hospital in a carousel fashion. The receiving doctors accepted patients without question and efficiently reviewed each and every one to ensure safe ongoing treatment.

> The unspoken realisation that these people were the supposedly “lucky” ones strengthened our resolve to do everything we could 

At our hospital senior members of staff started coordinating the receiving units. I was amazed by how many people turned up to help: nurses who were off duty came in; doctors on …
Hereditary haemochromatosis: to screen or not
Authors: J. E Haddow, L. A Bradley
Journal: BMJ (1999)

During the past several years hereditary haemochromatosis has risen from relative obscurity to become a topic of intense interest in the health community. Traditionally, hereditary haemochromatosis has been viewed as a rare inherited disorder, primarily of older men, that presents with life threatening complications such as “bronzed diabetes” (skin pigmentation, diabetes, and cirrhosis), primary liver cancer, or heart failure. Knowledge gained in the past 30 years, however, has shown that hereditary haemochromatosis occurs in as many as 5 in every 1000 white people of northern European heritage.1 The classic “bronzed diabetes” presentation is actually rare because it represents only a small proportion of affected individuals, usually those in whom the diagnosis has been missed for many years.2 This disorder more often presents in both men and women with non-specific medical complaints, such as abdominal pain, fatigue, sexual dysfunction, or joint pain, and hereditary haemochromatosis is often overlooked as a potential explanation.1 2 As iron loading progresses many organs and tissues can be damaged, leading to hepatic fibrosis and cirrhosis, primary liver cancer, endocrine dysfunction, cardiomyopathy, or arthropathy.1 2

For over 10 years laboratory tests for assessing iron burden (transferrin saturation, serum ferritin) have been widely used in population screening, in conjunction with diagnostic …
NON-OPERATIVE RESULTS IN NINETY PATIENTS WITH ABNORMAL CHOLECYSTOGRAMS
Authors: Staige D. Blackford, Robert M. Bird, S. Ward Casscells
Journal: Annals of Internal Medicine (1942)

Article1 June 1942NON-OPERATIVE RESULTS IN NINETY PATIENTS WITH ABNORMAL CHOLECYSTOGRAMSSTAIGE D. BLACKFORD, M.D., F.A.C.P., ROBERT M. BIRD JR., M.D., S. WARD CASSCELLS, M.D.STAIGE D. BLACKFORD, M.D., F.A.C.P.Search for more papers by this author, ROBERT M. BIRD JR., M.D.Search for more papers by this author, S. WARD CASSCELLS, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-16-6-1118 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe literature contains many reports indicating the effectiveness of medical treatment in gall-bladder disease. However, Walters and Snell1believe that in many of these reports there is an element of wishful thinking in the interpretations of the results. They point out that long-term observations of large groups of medically treated patients are rare, and they cite the report of J. M. Blackford, King and Sherwood2as one of the best. In that report, 200 cases diagnosed clinically as cholecystitis were reviewed by follow-up methods after an average period of nine and one-half years. However, the large majority of these cases...Bibliography1. WALTERSSNELL WAM: Diseases of the gall bladder and bile ducts, 1940, p. 377, Saunders, Philadelphia. Google Scholar2. BLACKFORDKINGSHERWOOD JMRLKK: Cholecystitis: study based on follow-up after from five to fifteen years of two hundred patients not operated on, Jr. Am. Med. Assoc., 1933, ci, 910-913. CrossrefGoogle Scholar3. WILSONLEHMANGOODWIN WDEPWH: Prognosis in gall bladder surgery, Jr. Am. Med. Assoc., 1936, cvi, 2209-2213. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: University, Virginia*Received for publication January 14, 1941.From the Department of Internal Medicine, University of Virginia Hospital. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAbstracts of current literature 1 June 1942Volume 16, Issue 6Page: 1118-1122KeywordsHospital medicine Issue Published: 1 June 1942 PDF downloadLoading ...
Effects of different regimens to lower blood pressure on major cardiovascular events in older and younger adults: meta-analysis of randomised trials
Authors: Fiona Turnbull, B Neal, T. Ninomiya, C. S. Algert, Hisatomi Arima, Federica Barzi, C. Bulpitt, J. P. Chalmers, R. Fagard, A. Gleason, Stephane Heritier, Nicole Li, Vlado Perkovic, Mark Woodward, Stephen MacMahon
Journal: BMJ (2008)

Objective To quantify the relative risk reductions achieved with different regimens to lower blood pressure in younger and older adults. Design Meta-analyses and meta-regression analyses used to compare the effects on the primary outcome between two age groups (<65 v ≥65 years). Evidence for an interaction between age and the effects of treatment sought by fitting age as a continuous variable and estimating overall effects across trials. Main outcome measures Primary outcome: total major cardiovascular events. Results 31 trials, with 190 606 participants, were included. The meta-analyses showed no clear difference between age groups in the effects of lowering blood pressure or any difference between the effects of the drug classes on major cardiovascular events (all P≥0.24). Neither was there any significant interaction between age and treatment when age was fitted as a continuous variable (all P>0.09). The meta-regressions also showed no difference in effects between the two age groups for the outcome of major cardiovascular events (<65 v ≥65; P=0.38). Conclusions Reduction of blood pressure produces benefits in younger (<65 years) and older (≥65 years) adults, with no strong evidence that protection against major vascular events afforded by different drug classes varies substantially with age.
The Unique Pharmacological Characteristics of Mifepristone (RU486): From Terminating Pregnancy to Preventing Cancer Metastasis
Authors: Jianzhong Chen, Jichuang Wang, Jingwei Shao, Yu Gao, Jianguo Xu, Suhong Yu, Zhenhua Liu, Lee Jia
Journal: Medicinal Research Reviews (2014)

Abstract Mifepristone (RU486) is a born‐for‐woman molecule discovered three decades ago. Unlike those antihypertensive and antipsychotic pharmaceutical blockbusters, this abortifacient offers relatively low profit potential. Current understanding of mechanism of action of mifepristone and its on‐going clinical trials are changing our views on the drug beyond its abortifacient scope. Here we briefly review its metabolism and pharmacokinetic properties including its unique enterohepatic circulation, its mechanisms of actions involving antiprogesterone and antiglucocorticoid, growth inhibition of various cancer cell lines, suppression of invasive and metastatic cancer potential, downregulation of Cdk2, Bcl‐2, and NF‐kappa B, interference of heterotypic cell adhesion to basement membrane, and cell migration. We comprehensively analyze recent results from preclinical and clinical studies using mifepristone as an anticancer drug for breast, meningioma, and gliomas tumors in the central nervous system, prostate cancer, ovarian and endometrial cancer, and gastric adenocarcinoma. Although mifepristone has more benefits for global public health than we originally thought, its effect as a postmetastatic chemotherapeutic agent is limited. Nonetheless, owing to its unique safe, metabolism and other pharmacological properties, metapristone (the primary metabolite of mifepristone) may have potential for cancer metastatic chemoprevention.
Abstract 12435: Coronary Artery Calcium Score of Zero Predicts Lower All-Cause Mortality Over a Long-Term Follow-Up
Authors: Joseph T Knapper, Taylor Lebeis, Geoff Southmayd, Pratik Sandesara, Michael J Blaha, Daniel Berman, Arshed Quyyumi, Michael J Budoff, James K Min, Valentina Valenti, Tracy Q Callister, Ashley E Giambrone, Leslee J Shaw
Journal: Circulation (2014)

Background: Coronary artery calcium (CAC) scoring has been shown in numerous studies to correlate well with adverse cardiovascular outcomes. In particular, a CAC score of zero has been linked with excellent survival. However, the majority of studies report only short-term follow-up results, and there is little data available on the long-term significance of a zero CAC score. Methods: A total of 9,074 (53±10 years, 60% male) consecutive asymptomatic individuals, free of known coronary heart disease (CHD), underwent CAC Agatston scoring for cardiovascular risk assessment. CHD risk factors were prospectively obtained by patient interview. Unadjusted and risk-factor adjusted Cox proportional hazard modeling was used to estimate time to all-cause mortality (median follow-up=14.7 years) by CAC subsets and was compared to general population mortality estimates. Results: Of all patients enrolled, 4,537 (50.0%) had a CAC score of zero. Annual all-cause mortality, based on adjusted Cox hazard modeling, was significantly lower in both men and women with a CAC score of zero than would be predicted for the general population (see Figure ). The median reduction in projected annual mortality was 68.4% for men and 51.2% for women, with the degree of mortality reduction increasing with age. Compared to a CAC score of zero, even a low-risk CAC score of 1-10 was associated with an increased risk of all-cause mortality (HR = 4.19, 1.97, 2.44 * , 1.82 * , and 1.70 * at 1, 3, 5, 10, and 15 years of follow-up, respectively), though importantly this effect did not reach statistical significance until 5 years of follow-up. Conclusion: A CAC score of zero is associated with a markedly decreased risk of all-cause mortality compared to the general population, and its significance increases with both age and length of follow-up.
The Role of Endomyocardial Biopsy in the Management of Cardiovascular Disease
Authors: Leslie T. Cooper, Kenneth L. Baughman, Arthur M. Feldman, Andrea Frustaci, Mariell Jessup, Uwe Kuhl, Glenn N. Levine, Jagat Narula, Randall C. Starling, Jeffrey Towbin, Renu Virmani
Journal: Journal of the American College of Cardiology (2007)
Oxygen saturation response during the six-minute walk test in patients with chronic respiratory disease
Authors: Raúl Carriόn-Sevilla, Elena Gimeno-Santos, Diego A. Rodriguez, Alba Ramirez-Sarmiento, Joaquim Gea, Josep Roca, Mauricio Orozco-Levi, Jordi Vilarό
Journal: European Respiratory Journal (2011)

Some guidelines recommend stopping 6-minute walk test (6MWT) if arterial oxygen saturation (SaO2) <85% as safety criteria. Our aim was to analyze the SaO2 response <85% during 6MWT and its relation with clinical and symptomatic outcomes.

Methods: Retrospectively, we analyzed 6MWT from two respiratory medicine services from tertiary hospitals: Hospital del Mar and Hospital Clinic, Spain, from 2006 to 2010. They did not stop 6MWT using SaO2<85% criteria. We analyzed the data in 4 groups according SaO2.

Results: 796 patients (68±10 years) were analyzed. The results of ANOVA are:

View this table:



Only 2 (0.5%) patients showed complications (leg pain and leg paresthesias) within groups (p=0.43). Few patients stopped during 6MWT in all groups (p=0.15).

Conclusions: Patients with SaO2<85% during 6MWT showed less distance walked and poor functional parameters. However, this group did not show differences neither in number of patients who stopped during the test nor presence of clinical complications during and after 6MWT. Our results confirm there are not critical effects in this kind of patients to stop the test using the SaO2<85% criteria.
First isolation of Legionella species, including L. pneumophila serogroup 1, in Greek potting soils: possible importance for public health
Authors: E.N. Velonakis, I.M. Kiousi, C. Koutis, E. Papadogiannakis, F. Babatsikou, A. Vatopoulos
Journal: Clinical Microbiology and Infection (2009)
New diagnostic marker found for glaucoma
Authors: Abi Berger
Journal: BMJ (2001)

The pathogenesis of glaucoma apparently involves the same cell adhesion molecule that is implicated in the development of vascular diseases. Scientists have discovered that the “endothelial leucocyte cell adhesion molecule 1” (ELAM-1) is present in the eyes of patients with glaucoma but not in healthy eyes. This is the first known molecular marker for glaucoma and may lead to an early genetic screening test ( Nature Medicine 2001;7:304-9).

Dr …
Disarming Violent Domestic Abusers Is Key to Saving Lives, Say Experts
Authors: Thomas B Cole
Journal: JAMA (2004)

EARLIER THIS YEAR, THE MURDER OF Christen Naujoks, a 22-year-old university student, made national headlines, though the circumstances that led to her death involved a scenario that is all too common. Naujoks had recently ended a relationship with her boyfriend, John Peck—but he was not willing to let her go. In cards and telephone messages, he was demanding and threatening. Court documents indicated that he vowed to take one of his father’s guns and kill himself on her doorstep. The campus police and the county sheriff’s department advised the frightened woman about measures to protect herself; she followed their recommendation to obtain a protective order that instructed Peck to stay away from her and surrender his firearms. About 3 weeks later, however, Peck confronted Naujoks outside her apartment building and killed her with an assault rifle. Days later, he shot and killed himself while fleeing police.
Abstract P260: Obesity is Associated With DNA Methylation in Population-Based Adolescents
Authors: Arthur Berg, Yuka I Kawasawa, Anna Salzberg, Edward O Bixler, Fan He, Duanping Liao
Journal: Circulation (2015)

Introduction: The association between obesity and DNA methylation in adolescents are extremely limited.

Hypothesis: We hypothesize that gene specific methylations are associated with obesity in population-based adolescents.

Methods: From the population-based Penn State Child Cohort follow-up exam (N=421), we randomly selected 20 obese cases from those with BMI percentile > 95, and 20 nonobese controls from those with BMI percentile < the median (61). White Blood Cell DNA was subjected to enhanced reduced representation bisulfite sequencing providing single nucleotide resolution of DNA methylation in CpG sites and surrounding regions. Briefly, 20 ng of genomic DNA was digested by MspI, which recognizes and cleaves CpG sites, followed by end repair, adenylation and adapter ligation using NEXTflex Bisulfite-Seq Library Prep Kit and NEXTflex Bisulfite-Seq Barcodes with a modification of bead size selection to capture MspI fragments of 70-320 bp size. The resulting libraries were bisulfite-converted by using EZ DNA Methylation Kit, followed by 18 to 20 cycles of PCR amplification using the NEXTflex Bisulfite-Seq U+PCR Master Mix and NEXTflex Primer Mix. Purified and quantified libraries were pooled at 6 samples per sequencing lane and read by 1X50 bp on HiSeq 2500. CASAVA-demultiplexed .fastq files were subjected to downstream analyses. Base calls of bisulfite treated sequencing reads with phred quality scores < 20 were trimmed and the adaptor was cut using trim_galore v0.3.3. Resulting reads were mapped to the hg19 assembly and methylation calls were performed using Bismark v0.10.1. Analysis was performed using custom R scripts and methylKit v0.9.2. Bases with less than 10x coverage were excluded. Bases with fewer than 5 subjects in either the obese or nonobese groups were also excluded. Significance at each base was assessed with t-test. A gene-level analysis was conducted by selecting only bases with a p-value < .05 and identifying genes with the largest number of differentially methylated bases after normalizing by gene length.

Results: We identified 4136 bases with statistically significant differential methylation and an average difference of 25% or more. The genes with the most differentially methylated bases after normalizing to the gene length are GADD45B (8 bases), NKX6-2 (5 bases), UNCX (7 bases), KCNG2 (5 bases). Other significant genes include GNAS (8 bases), KIF26A (8 bases), TBX3 (8 bases), PDGFB (7 bases), B3GALT6 (6 bases), DLG3 (6 bases), GRIN3B (6 bases). Methylkit also identified the following significantly differentially methylated genes:

LINC01444, GPR123, PTP4A3, SH3PXD2A-AS1, ZNF835. One base on the PHYKPL gene maintained significance (p=.01) after multiple correction at the chromosome level.

Conclusion: Obesity is associated DNA methylation in otherwise healthy adolescents. Future analysis will focus on validating significant findings in a larger cohort.
Lecturing the Interns
Authors: Phil Bowman
Journal: JAMA (2003)

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Androgenetic alopecia in the paediatric population: a retrospective review of 57 patients
Authors: M. E. Gonzalez, J. Cantatore-Francis, S. J. Orlow
Journal: British Journal of Dermatology (2010)

Hair loss is an unwelcome event at any age, but it can be particularly distressing for adolescents and their families. While androgenetic alopecia (AGA) is the most common form of hair loss in adults, little is known about its prevalence, clinical features and response to treatments in the paediatric population.To better characterize the causes of alopecia in a paediatric population.We performed a retrospective chart review to identify all patients with hair loss seen in an academic paediatric dermatology practice at New York University over a 12-year period to better characterize the causes of alopecia in this population. We review the clinical and histological features, natural progression and associated laboratory abnormalities of AGA in 57 paediatric patients.AGA was identified as the most frequent cause of hair loss in adolescents and the second most common diagnosis overall. The male to female ratio was 2 : 1 and the average age at initial presentation with AGA was 14.8 years. Adolescent girls had diffuse thinning or thinning at the crown, and boys frequently presented with female pattern hair loss. When biopsies were performed, perifollicular inflammation was a common finding. A family history of AGA was reported in 83% of patients. Laboratory evaluation for androgens revealed polycystic ovarian syndrome in three girls and late-onset congenital adrenal hyperplasia in one boy.AGA is the most common form of hair loss in adolescents, and can be the presenting sign of an underlying endocrine disorder. An accurate and timely diagnosis is essential for appropriate medical and psychosocial intervention when warranted.