tbuckley/cabot-search huggingface dataset:
Normal lower limb variants in children
Authors: Andrea Yeo, Kyle James, Manoj Ramachandran
Journal: BMJ (2015)

#### The bottom line

Bow legs, knock knees, flat feet, intoeing, and out-toeing gaits in children are common but often cause undue parental anxiety, prompting frequent visits to general practice.1 2 3 4 5 A substantial proportion of referrals to paediatric orthopaedic clinics consist of normal physiological variants in growing children. Careful history, examination, and knowledge of the clinical course of rotational and angular deformities allow accurate assessment of children and provide reassurance to parents. Our review aims to assist general clinicians in recognising normal physiological variants in the lower limbs of children and to identify abnormal features that require specialist attention.

#### Sources and selection criteria

We searched PubMed and Google Scholar using the terms “p(a)ediatric”, “lower limb variants”, “intoeing”, “out-toeing”, “pes planus”, “flat foot”, “genu varum”, “genu valgum”, “vitamin D deficiency”, “obesity”, and “sporting activity”. The search was conducted from inception of databases to March 2015. Wherever possible we used evidence from randomised controlled trials, systematic reviews (including Cochrane reviews), and expert review articles published in the past 10 years. Current relevant Department of Health policies were also included. 

Musculoskeletal symptoms are one of the leading causes of visits to primary care doctors …
Safety of<i>Bifidobacterium animalis</i>subsp.<i>lactis</i>(<i>B. lactis</i>) strain BB-12-supplemented yogurt in healthy adults on antibiotics: a phase I safety study
Authors: Daniel J Merenstein, Tina P Tan, Aleksey Molokin, Keisha Herbin Smith, Robert F Roberts, Nawar M Shara, Mihriye Mete, Mary Ellen Sanders, Gloria Solano-Aguilar
Journal: Gut Microbes (2015)

Probiotics are live microorganisms that, when administered in sufficient doses, provide health benefits on the host. The United States Food and Drug Administration (FDA) requires phase I safety studies for probiotics when the intended use of the product is as a drug. The purpose of the study was to determine the safety of Bifidobacterium animalis subsp lactis (B. lactis) strain BB-12 (BB-12)-supplemented yogurt when consumed by a generally healthy group of adults who were prescribed a 10-day course of antibiotics for a respiratory infection. Secondary aims were to assess the ability of BB-12 to affect the expression of whole blood immune markers associated with cell activation and inflammatory response. A phase I, double-blinded, randomized controlled study was conducted in compliance with FDA guidelines for an Investigational New Drug (IND). Forty participants were randomly assigned to consume 4 ounces of either BB-12 -supplemented yogurt or non-supplemented control yogurt daily for 10 d. The primary outcome was to assess safety and tolerability, assessed by the number of reported adverse events. A total of 165 non-serious adverse events were reported, with no differences between the control and BB-12 groups. When compared to the control group, B lactis fecal levels were modestly higher in the BB-12-supplemented group. In a small subset of patients, changes in whole blood expression of genes associated with regulation and activation of immune cells were detected in the BB-12-supplemented group. BB-12-supplemented yogurt is safe and well tolerated when consumed by healthy adults concurrently taking antibiotics. This study will form the basis for future randomized clinical trials investigating the potential immunomodulatory effects of BB-12-supplemented yogurt in a variety of disease states.
Comparison of the diagnostic yield of bronchoscopy in the investigation of suspected tuberculosis in patients with and without parenchymal changes
Authors: Yasser Madani, Bhupinder Mann, Solomon Bogale
Journal: European Respiratory Journal (2013)

Introduction  Tuberculosis (TB) continues to increase in incidence worldwide. Intrathoracic TB lymphadenitis without parenchymal changes presents a diagnostic challenge.  Objective  To compare the diagnostic yield of bronchoscopy in suspected TB with and without parenchymal changes.  Methods  49 patients with suspected TB between 2007 and 2010 were identified using bronchoscopy records in a small district general hospital serving a large migrant population in west London.  Results  Patients were divided into two groups; those with parenchymal changes (Group 1, n=38) and those with isolated intrathoracic lymphadenopathy (Group 2, n=11). All patients were initially either sputum smear negative or were non-productive.  The overall yield of bronchoscopy in Group 1 was 42% (16/38). Culture was positive in 14 (37%) and exclusively positive in 7 (18%). Microscopy was positive in 6 (16%) and exclusively positive in 1 (2%). Histology from endobronchial biopsy (EBB) was positive in 3 (8%) and exclusively positive in 1 (3%).  In Group 2, the overall yield of bronchoscopy was 18% (2/11). In both cases the diagnosis was exclusively provided by histology from EBB. Two patients required mediastinoscopy and one required fine needle aspiration from a cervical lymph node. All three results were consistent with TB.  Conclusion  Diagnosis of isolated intrathoracic TB lymphadenitis presents a challenge. EBB may be a useful alternative where transbronchial needle aspiration (TBNA) is locally unavailable. Bronchial washings and lavage in this setting are not useful. Where clinical suspicion of other pathology remains high, TBNA or mediastinoscopy must be pursued.
Whole genome sequencing of clinical isolates of Giardia lamblia
Authors: K. Hanevik, R. Bakken, H.R. Brattbakk, C.S. Saghaug, N. Langeland
Journal: Clinical Microbiology and Infection (2014)

<h2>Abstract</h2> Clinical isolates from protozoan parasites such as <i>Giardia lamblia</i> are at present practically impossible to culture. By using simple cyst purification methods, we show that <i>Giardia</i> whole genome sequencing of clinical stool samples is possible. Immunomagnetic separation after sucrose gradient flotation gave superior results compared to sucrose gradient flotation alone. The method enables detailed analysis of a wide range of genes of interest for genotyping, virulence and drug resistance.
Abstract 17316: Inhibition of Calcineurin/NFAT Signaling During Exercise Training Protects the Heart Against Myocardial-Ischemia Reperfusion Injury
Authors: Bridgette Moody, Rebecca L Hood, Chad K Nicholson, David J Lefer, John W Calvert
Journal: Circulation (2011)

Background: Exercise training confers sustainable protection against ischemia-reperfusion injury in animal models and has been associated with improved survival following a heart attack in humans. It is still unclear how exercise protects the heart, but there is evidence to suggest that during heart failure exercise training can reduce the cardiac activity of nuclear factor of activated T-cells (NFAT), a transcription factor associated with pathological hypertrophy and cell death. However, the mechanism(s) responsible for this inhibition is not fully understood and it is not known if the inhibition of NFAT is associated with the preconditioning effects of exercise. Therefore, we investigated if exercise could precondition the heart by inhibiting NFAT. Methods and Results: Mice (C57BL/6J) that engaged in voluntary exercise for 4 wks (VE 4 wks) revealed an 18% reduction in infarct size per area-at-risk (INF/AAR) following 45 min of myocardial ischemia and 24 hr of reperfusion when compared to sedentary (SED) mice (49 vs. 60%, p&lt;0.05) and a 37% reduction in circulating troponin-I levels when compared to SED mice (45 vs. 28 ng/mL, p&lt;0.05). In separate experiments, SED and VE mice were sacrificed immediately after the training period and heart tissue was excised and processed for Western blot analysis. We found that VE decreased the nuclear expression of both NFATc2 and NFATc4 in the hearts of the trained mice when compared to the SED mice. Further analysis revealed that VE did not alter the expression of the calcium-calmodulin-activated protein phosphatase calcineurin-Aβ (CnAβ), but did increase the expression of the calcineurin inhibiting sarcomeric protein calsarcin-1 and increased the association of calsarcin-1 and CnAβ. Conclusions: This data suggests that exercise training potentially protects the heart against MI/R upregulating the expression of calsarcin-1, which leads to an inhibition of Cn/NFAT signaling.
The military family syndrome
Authors: Don M. LaGrone
Journal: American Journal of Psychiatry (1978)

The author reviewed the case records of 792 children and adolescents seen in a military clinic over a two-year period. His data suggest that the incidence of behavioral disorders was higher in this clinic than in a civilian mental health center. Seven problem areas common to records in which a behavioral disorder was diagnosed were found. The author suggests that the behavioral problems of the group studied represent a process of acting out in the rigid, autocratic system of the military. He also suggests that an approach using systems theory and modified goals may be more helpful in dealing with problems of military families than the traditional individual approach.
Practice patterns in the management of acute asthma and COPD in Turkey
Authors: Erdogan Cetinkaya, Sadik Ardic, Hilal Onaran, Pinar Cirkin, Ozlem Salman Sever
Journal: European Respiratory Journal (2012)

Introduction  The recognition and management of the asthma and COPD exacerbations is a cornerstone in the achievement of optimum control of these diseases.  Aims and objectives  The “ONDINE Study” aimed to evaluate practice patterns in the management of acute asthma and COPD in Turkey.  Methods  Patients with asthma or COPD were included in this national, multicenter, cross-sectional, non-interventional study. Patient demographics, control level, exacerbation severity and the exacerbation management of asthma and COPD were evaluated.  Results  A total of 596 patients included in the study having the diagnosis of asthma [n=301; mean (standard deviation; SD) age: 45 (13) years; 74% were females] or COPD [n=295; mean (SD) age: 62 (11) years; 86% males]. Disease control was evident in 38% of COPD patients while in 51% of asthma patients while severe COPD (31%) and intermittent asthma (51%) were the most common forms of disease severity. Hospital admission due to an acute exacerbation within the last 12 months was identified in 75% of asthma and 78% of COPD patients. Emergency and intensive care unit hospitalization rates were 40% and 1% in asthma patients and 53% and 2% in COPD patients, respectively. The most commonly performed tests in asthma and COPD patients were chest XR (98% and 99%) and spirometry (98% and 99%). Long-acting beta-agonist and inhaled corticosteroid combination was the most common continuous prophylactic treatment (69%) in asthma and (71%) in COPD.  Conclusions  The study revealed that acute asthma exacerbations were managed better than COPD exacerbations and higher control rates were obtained in both diseases as exacerbation were managed more appropriate with respect to recommendations in the guidelines.
Excretion of sterols from the skin of normal and hypercholesterolemic humans
Authors: Ashim K. Bhattacharyya, William E. Connor, Arthur A. Spector
Journal: Journal of Clinical Investigation (1972)

The 24 hr sterol excretion from the entire skin surface was determined in six normal and five hypercholesterolemic (Type II) patients fed a controlled, eucaloric diet containing 400 mg of plant sterols. All subjects received radiolabeled cholesterol intravenously in order to measure cholesterol turnover and exchange. The 24 hr skin surface lipids were collected subsequently at intervals of 7-10 days. Sterols were quantified and identified by a combination of thin-layer and gas-liquid chromatographic methods. The mean 24 hr excretion of cholesterol in milligrams was 82.6 in the normal subjects and 82.7 in the hypercholesterolemic patients. Cholesterol constituted 89% of the total sterol excretion through the skin surface in both groups. The specific radioactivity of cholesterol in the skin surface lipids increased gradually after the intravenous administration of the isotope. Within 4-5 wk the specific activity equaled and then remained higher than that of the plasma up to 10 wk. These specific activity curves suggested that, for at least some of skin surface cholesterol, there was a precursor-product relationship between the plasma cholesterol and the skin cholesterol. The presence of plant sterols, beta-sitosterol, campesterol, and stigmasterol in the skin surface lipids of man has not been reported previously. We identified these sterols in the skin surface lipids of all of our subjects. They constituted about 7% of the total skin surface sterols. The occurrence of plant sterols in the skin surface lipids suggested that plasma sterols were transferred from the plasma into the skin. 1-2% of the skin surface sterols were tentatively identified as lathosterol and lanosterol. The present study documented that a significant amount of cholesterol was excreted from the skin surface and that probably there was a net transfer of plasma cholesterol into the skin surface lipids. Both normal subjects and hypercholesterolemic patients excreted similar amounts of cholesterol per day into the skin surface lipids. We suggest that this daily loss of cholesterol from the skin surface may need to be considered in sterol balance studies.
Hyperglycemia, hypertriglyceridemia, and hypercholesterolemia in a phase I trial of the combination of an mTOR inhibitor and IGF-1 receptor inhibitor.
Authors: N. Busaidy, R. Kurzrock, P. LoRusso, A. D. Owens, H. X. Chen, L. Doyle, J. Zhang, K. Lawhorn, C. Chandhasin, A. Naing
Journal: Journal of Clinical Oncology (2010)

2597 Background: Cixutumumab (a fully humanized IgG1 monoclonal antibody directed at IGF-1R) and the mammalian target of rapamycin (mTOR) inhibitor (temsirolimus) were combined in a multicenter phase I study supported in part by 5UO1CA062461-14[RK], 5U01CA062487-17 [PL] and 1R21CA13763301A1 [AN]. Objectives of the NCI study #8109 were to evaluate toxicities and define the MTD of this combination aimed at enhancing anticancer activity via modulation of resistance to mTOR inhibition. The most common adverse events were metabolic in nature, including hyperglycemia, hypercholesterolemia, and hypertriglyceridemia. Methods: This “3+3” phase I trial used a fixed temsirolimus dose of 25 mg IV weekly with escalating doses of cixutumumab to 3, 4 or 6 mg/kg IV weekly. By design, no patients with diabetes or hyperlipidemia at baseline were entered until the expansion cohort. All patients who developed hyperlipidemia or hyperglycemia were monitored or treated by specialists according to a specific treatment algorithm. Results: Of the 32 patients (pts) analyzed, hyperglycemia was seen in 17 (53%) (grade 1-2: 14 [44%], grade 3: 3 [9%]). The average blood sugar across cohorts was 113 mg/dL. No patient developed diabetic ketoacidosis or nonketotic hyperosmolar coma during treatment. Patients were treated primarily with oral hypoglycemic agents (3), insulin (2), combination (2) or lifestyle only (3). Hypertriglyceridemia occurred in 18 pts (56%) (grade 1-2: 17 [53%], grade 4:1 [3%]) and hypercholesterolemia in 18 (56%) pts (grade 1-2). They were treated with triglyceride lowering agents such as fenofibrate or omega 3 fatty acids (12), statins (11), or a combination (3) or lifestyle only (2). No patient developed pancreatitis. Conclusions: The combination of cixutumumab and temsirolimus was well tolerated with adverse metabolic events of hyperglycemia and hyperlipidemia. With appropriate oversight and treatment, these adverse events were treatable and major complications were avoided. No significant financial relationships to disclose.
The medical selfie
Authors: Arunava Ray, Annabel Diane Scott, Dariush Nikkhah, Baljit S Dheansa
Journal: BMJ (2015)

“Selfie,” the 2013 word of the year according to Oxford Dictionaries, denotes a photograph taken of oneself with either a smartphone or a webcam (http://blog.oxforddictionaries.com/2013/11/an-infographic-of-selfie). The latest craze of selfies among the wider population has come under some criticism, with perpetrators labelled “narcissists” or the craze seen as yet another teenage fad.1

We, unlike many of our patients, have been reticent in the uptake of rapidly evolving technology within the NHS; none more so than using “clinical photography” to aid in understanding the dynamic nature of disease processes. …
Cleaved c-FLIP mediates the antiviral effect of TNF-α against hepatitis B virus by dysregulating hepatocyte nuclear factors
Authors: Yong Kwang Park, Eun-Sook Park, Doo Hyun Kim, Sung Hyun Ahn, Seung Hwa Park, Ah Ram Lee, Soree Park, Hong Seok Kang, Ji-Hyun Lee, Jong Man Kim, Suk-Koo Lee, Keo-Heun Lim, Nathalie Isorce, Shuping Tong, Fabien Zoulim, Kyun-Hwan Kim
Journal: Journal of Hepatology (2015)
Methionine and S-adenosylmethionine levels are critical regulators of PP2A activity modulating lipophagy during steatosis
Authors: Imanol Zubiete-Franco, Juan Luis García-Rodríguez, Maite Martínez-Uña, Nuria Martínez-Lopez, Ashwin Woodhoo, Virginia Gutiérrez-De Juan, Naiara Beraza, Sergio Lage-Medina, Fernando Andrade, Marta Llarena Fernandez, Luis Aldámiz-Echevarría, David Fernández-Ramos, Juan Manuel Falcon-Perez, Fernando Lopitz-Otsoa, Pablo Fernandez-Tussy, Lucía Barbier-Torres, Zigmund Luka, Conrad Wagner, Carmelo García-Monzón, Shelly C. Lu, Patricia Aspichueta, José María Mato, María Luz Martínez-Chantar, Marta Varela-Rey
Journal: Journal of Hepatology (2015)
Development of a single tube multiplex real-time PCR to detect the most clinically relevant Mucormycetes species
Authors: L Bernal-Martínez, M J Buitrago, M V Castelli, J L Rodriguez-Tudela, M Cuenca-Estrella
Journal: Clinical Microbiology and Infection (2012)

Mucormycetes infections are very difficult to treat and a delay in diagnosis could be fatal for the outcome of the patient. A molecular diagnostic technique based on Real Time PCR was developed for the simultaneous detection of Rhizopus oryzae, Rhizopus microsporus and the genus Mucor spp. in both culture and clinical samples. The methodology used was Molecular beacon species-specific probes with an internal control. This multiplex real-time PCR (MRT-PCR) was tested in 22 cultured strains and 12 clinical samples from patients suffering from a proven mucormycosis. Results showed 100% specificity and a detection limit of 1 fg of DNA per microlitre of sample. The sensitivity was 100% for clinical cultured strains and for clinical samples containing species detected by the PCR assay. Other mucormycetes species were not detected in clinical samples. This technique can be useful for clinical diagnosis and further studies are warranted.
Abstract 14099: Prognostic Value of Coronary CT Angiography for the Prediction of Mortality and Non-Fatal Major Adverse Cardiac Events: Results from the Multinational CONFIRM Registry
Authors: Stephan Achenbach, Daniel S Berman, Matthew J Budoff, Tracy Q Callister, Hyuk-Jae Chang, Cheng Victor, Benjamin J Chow, Augustin DeLago, Allison M Dunning, Martin Hadamitzky, Joerg Hausleiter, Ronald P Karlsberg, Philipp A Kaufmann, Fay Y Lin, Mouaz Al-Mallah, Khurram Nasir, Leslee J Shaw, James K Min
Journal: Circulation (2011)

Background: The relationship between coronary CT angiography (CTA) findings and mortality is well documented, but data linking measures of atherosclerosis in coronary CTA to major adverse cardiac e...
Violations of sensorimotor theories of visual experience
Authors: Bruce Bridgeman
Journal: Behavioral and Brain Sciences (2004)

Although the sensorimotor account is a significant step forward, it cannot explain experiences of entoptic phenomena that violate normal sensorimotor contingencies but nonetheless are perceived as visual. Nervous system structure limits how they can be interpreted. Neurophysiology, combined with a sensorimotor theory, can account for space constancy by denying the existence of permanent representations of states that must be corrected or updated.
Novel Cell-Penetrating Peptide-Based Vaccine Induces Robust CD4+ and CD8+ T Cell–Mediated Antitumor Immunity
Authors: Madiha Derouazi, Wilma Di Berardino-Besson, Elodie Belnoue, Sabine Hoepner, Romy Walther, Mahdia Benkhoucha, Patrick Teta, Yannick Dufour, Céline Yacoub Maroun, Andres M. Salazar, Denis Martinvalet, Pierre-Yves Dietrich, Paul R. Walker
Journal: Cancer Research (2015)

Abstract Vaccines that can coordinately induce multi-epitope T cell–mediated immunity, T helper functions, and immunologic memory may offer effective tools for cancer immunotherapy. Here, we report the development of a new class of recombinant protein cancer vaccines that deliver different CD8+ and CD4+ T-cell epitopes presented by MHC class I and class II alleles, respectively. In these vaccines, the recombinant protein is fused with Z12, a novel cell-penetrating peptide that promotes efficient protein loading into the antigen-processing machinery of dendritic cells. Z12 elicited an integrated and multi-epitopic immune response with persistent effector T cells. Therapy with Z12-formulated vaccines prolonged survival in three robust tumor models, with the longest survival in an orthotopic model of aggressive brain cancer. Analysis of the tumor sites showed antigen-specific T-cell accumulation with favorable modulation of the balance of the immune infiltrate. Taken together, the results offered a preclinical proof of concept for the use of Z12-formulated vaccines as a versatile platform for the development of effective cancer vaccines. Cancer Res; 75(15); 3020–31. ©2015 AACR.
Asthma management in schools: Survey of 110 physicians in school health
Authors: Med Abdellatif Bennani, Fatima Zahra Drissi, Souad Kebbati, Malika Guermaz
Journal: European Respiratory Journal (2013)

Introduction:  The school doctor plays a vital role in the detection, treatment and education of children with asthma because of his frequent visits to the school.   Aims and Methods:  In order to assess the school health doctors’ behavior and knowledge in asthma, 110 practitioners were randomly selected to answer a standardized questionnaire.   Results:  The 84 participated physicians in the study have a good general knowledge of asthma diagnosis. However, only 19% of physicians knew all the criteria of asthma harshness. Among the 84 doctors who performed a demonstration of the use of inhaled devices, 12% have fulfilled all the steps for a spray pump usage. These results are comparable to other GPs for which the misuse varies from 58 to 94%. The main expectation of asthmatic children toward the school physician for the management of asthma in school and how to use the devices prescribed, (87%) emphasizing the lack of information received or retained by asthmatic children during consultations.   Conclusion:  The knowledge enhancement of signs of severe asthma attack and the use of inhaled devices could advantageously be one of school doctor promotion.