tbuckley/cabot-search huggingface dataset:
How does it work?: Bone mineral density scans
Authors: A. Berger
Journal: BMJ (2002)

…; In bone mineral density (BMD) scanning, the energy of x ray beams that are passed through bones is absorbed, and what is not absorbed is detected on the other side of the body. The more dense the bones (from greater mineral content), the more energy is absorbed, and the less energy detected. 

…; The radiation energy per pixel (“picture element”) is detected and converted into an “areal density” measured in g/cm2. The number of pixels in the area is summed, then the amount of bone in each pixel is calculated. This allows a bone density to be calculated for the specific bone in question.

…; Basic BMD measurement requires the patient to be “on the table” …
TV: Trust me, I'm a surgeon
Authors: A. Berger
Journal: BMJ (2000)

Trust Me, I'm a Doctor , BBC2, Wednesday 22 March at 7 30 pm

“The only place where Bristol isn't going to happen again is Bristol,” warned a parent of one of the babies who died in Bristol on television last week. It makes sense. Shamed by disaster into openly publishing mortality figures for individual surgeons performing specific operations, paediatric cardiac surgery at Bristol must now be the most closely scrutinised surgical department in the country. And also the most transparent. See for yourself; the figures are posted on the internet. Bristol can hold its collective head up—paediatric cardiac surgery now boasts a better mortality figure than the national average.

But apart from this fairly radical departure from the medical cultural norm in Britain, the rest of the country remains largely in the dark about surgical performance. Outcome measures do not fall readily to hand. According to this …
Recent Advances: Orthopaedic and trauma surgery
Authors: C. J K Bulstrode
Journal: BMJ (1995)

Over the past few years there have been enormous changes in orthopaedic and trauma surgery, but whether they are also advances is not known. Like every other clinical specialty this one desperately lacks the tools, the will, and the resources to assess whether each change is an advance or merely another passing fashion.

In this article I will review the major changes which have taken place in musculoskeletal surgery and point out where they most urgently need assessing.

Trauma surgery continues to dominate the workload of most orthopaedic surgeons, encroaching on resources needed for elective surgery. Fractured neck of femur remains the bread and butter of trauma. The numbers continue to rise,1 but the average length of stay in many units has fallen.2 This is possibly through increased liaison between geriatricians, orthopaedic surgeons, and the community, but it may also reflect the fairly new attitude that acute hospital beds are an expensive resource and that there is no worse place for an elderly patient than in bed in hospital.3 Patients may be moving from acute beds more rapidly, but perhaps they are simply transferring to non-acute beds, where they may actually stay much longer.4 The faster turnover of acute trauma beds may not be serving patients or even the health service as well as it might first seem. There is a great need for a large multicentre study to look at (a) whether early surgery improves the long term outcome, (b) the effect of the type of fixation used and the experience of the operator (most of these operations are performed by junior surgeons), and (c) the cost-benefit of rehabilitation performed in an acute hospital, in a rehabilitation unit, or at home.

The management of major trauma at its earliest stages has changed beyond recognition with …
Periungual and subungual pyogenic granuloma
Authors: B.M. Piraccini, S. Bellavista, C. Misciali, A. Tosti, D. De Berker, B. Richert
Journal: British Journal of Dermatology (2010)

Background Nail pyogenic granuloma (PG) is common, often seen as an urgent case, given the recent onset as a bleeding nodule. Nail PGs are due to different causes that act through different pathogenetic mechanisms and may be treated in several ways. Both causes and treatments of nail PG have never been classified. Objectives To classify nail PG according to the pathogenesis, describe the clinical and pathological features and provide guidelines for a correct diagnosis and treatment. Methods A retrospective, observational study was performed reviewing epidemiological and clinical features of 58 cases of PG seen at our Departments in the last 5 years. A review of the literature was also carried out, using PubMed database and dermatological textbooks. Results Nail PG is usually due to the following causes: drugs, local trauma and peripheral nerve injury. Histopathology shows similar features in every type of PG, irrespective of cause and location. Conclusions The localization of nail PG, the number of digits involved and clinical history help to identify the cause. When PG is single, especially if it involves the nail bed, histological examination is necessary to rule out malignant melanoma. Treatment must be chosen according to the underlying cause.
Abstract 5773: Reduced Left Ventricular Vortex Formation Ability Despite Preserved Ejection Fraction in Low-Flow, Low-Gradient Severe Aortic Stenosis
Authors: Li Ching Lee, Sher Lynn Lim, Huay Cheem Tan, Boon Lock Chia, Kian Keong Poh
Journal: Circulation (2008)

Background and Aim : Low-flow, low-gradient (LFLG) severe aortic stenosis (AS) despite preserved left ventricular (LV) ejection fraction (EF) has been associated with more advanced stage of the disease, lower cardiac output (CO) and higher systemic afterload. We aim to characterize the LV performance determinants, including its vortex formation (VF) ability. Methods : Echocardiography was performed in 61 consecutive patients with severe AS (aortic valve area index (AVAI) ≤ 0.6 cm 2 /m 2 ) and preserved LVEF (≥ 50%). In addition to biplane LV measurements, AS severity indices and Tei index were measured. Hemodynamic indices (including systemic vascular resistance (SVR) and valvulo-arterial impedance (VAI)) were calculated. VF index (VFI) was obtained from 4 X (1-β)/πX α 3 X LVEF where β is the fraction of total transmitral diastolic stroke volume (SVol) contributed by atrial contraction (assessed by time velocity integral of the mitral E and A waves) and α is the end diastolic volume (EDV) 1/3 divided by mitral annular diameter during early diastole. Patients were categorized by their LV SVol index (SVI). LFLG group consisted of SVI &lt; 45ml/m 2 . Results : Mean VFI was 2.67±1.1; AVAI, 0.50±0.09 cm 2 /m 2 . Though AVAI was slightly lower in LFLG, dimensionless index and aortic valve resistance were similar and associated with no difference in LV mass and volume between the 2 groups. VFI was significantly reduced in the LFLG, 2.37±0.9 vs 3.12±1.3 ( P =0.01), However other LV functional parameters including Tei index and LVEF were similar (Table ). LFLG was associated with higher SVR and VAI (Table ). In LFLG, the only significant correlates of VFI were SVR (r=0.38), VAI (0.37) and stroke work index (0.36); all P s&lt;0.05. VFI did not correlate to these parameters in the non-LFLG group. Conclusion : In LFLG severe AS, increased afterload and suboptimal LV vortex formation ability contribute to lower CO/SV. VFI provides useful insights in understanding this relatively new entity. Comparison of echocardiographic and haemodynamic data in LFLG and non-LFLG groups
Abstract #1: E2F2 in eugenol-induced inhibitory activities in malignant melanoma
Authors: Rita Ghosh, Rumu Bose, Addanki Kumar
Journal: Cancer Research (2009)

AACR Annual Meeting-- Apr 18-22, 2009; Denver, CO

Malignant melanoma continues to be the most lethal skin cancer with limited therapeutic options. We have explored the use of naturally occurring compounds for malignant melanoma. Eugenol, a naturally occurring phenolic compound was found to produce significant tumour growth delay in the B16 melanoma model. Eugenol also induced cell cycle arrest and modulated expression and protein level of E2F family of transcription factors. We further investigated the role of E2F2 in the anti-cancer activities associated with eugenol. We knocked down E2F2 expression stably in the human metastatic melanoma cell line (1205Lu) using shRNA. We show that while the absence of E2F2 does not perturb the ability of eugenol to inhibit melanoma cell proliferation, it slowed down progression through G1 and S phases of the cell cycle. The oxidative DNA damage marker, 8-oxo-dG produced in response to eugenol treatment is repaired more efficiently in the absence of E2F2 which is accompanied by inhibition of eugenol-induced apoptosis. Taken together our results suggest that eugenol targets E2F2 to produce specific biological effects in metastatic malignant melanoma cells. Our study also does not rule out the possibility that members of the E2F family substitute for one another in specific functions. Our results call for further development of eugenol-mediated E2F family as a target in metastatic malignant melanoma since deregulation of E2F is associated with melanoma. Supported by NIH CA117366 (RG)

Citation Information: In: Proc Am Assoc Cancer Res; 2009 Apr 18-22; Denver, CO. Philadelphia (PA): AACR; 2009. Abstract nr 1.
Abstract 2505: Exposure to a therapeutically relevant dose of ionizing radiation reveals colorectal cancer biomarker and associated receptor alterations
Authors: Shubhankar Suman, Albert J. Fornace, Kamal Datta
Journal: Cancer Research (2014)

Abstract Purpose: Diagnostic and therapeutic radiation exposure to humans is inevitable, and radiation exposure is known to enhance risks of colorectal cancer (CRC) and inflammatory bowel diseases. Radiation exposure has also been observed to promote obesity in humans as well as in rodents. While altered levels of insulin like growth factor 1 (IGF1), leptin, and adiponectin have been reported as potential markers of obesity-related CRC risk, there is a paucity of long-term radiation-risk-markers for intestinal pathologies. The goal of the current study was to evaluate in mice whether obesity-related CRC risk markers have the potential to serve as radiation-associated CRC risk markers after exposure to a clinically relevant γ radiation dose. Methods and materials: Mice (C57BL/6J, 6-8 week old, female; n= 8 per group) were exposed to a γ radiation dose of 2 Gy, commonly used in fractionated radiotherapy. Serum and intestinal tissues were collected two and twelve months after radiation. Serum levels of IGF-1, IGF binding protein 3 (IGFBP3), leptin, and adiponectin were analyzed by enzyme-linked immunosorbent assay (ELISA). Immunohistochemistry was performed on small intestine and colon sections for IGF1 receptor (IGF1R), obesity receptor (OB-R), adiponectin receptor 1 (AdipoR1), adiponectin receptor 2 (AdipoR2) and proliferative marker Ki-67. Results: The levels of free IGF1 and free leptin measured by calculating IGF1/IGFBP3 and leptin/adiponectin ratio showed a distinct pattern. While significantly higher free IGF1 was observed twelve months post-radiation, higher free leptin was observed two months after radiation exposure. Immunohistochemical analysis demonstrated increased IGF1R and OB-R, decreased AdipoR1 and R2, and increased Ki67 in intestinal as well as in colonic sections at both the time points. Conclusions: Considering that one fraction of 2 Gy showed significant alterations in risk markers, we believe exposure to a higher total dose using more fractions will show more pronounced effects. Taken together, this study demonstrates that adipogenic risk markers of CRC could be effective tools to assess CRC risks after therapeutic γ radiation exposures. Note: This abstract was not presented at the meeting. Citation Format: Shubhankar Suman, Albert J. Fornace, Kamal Datta. Exposure to a therapeutically relevant dose of ionizing radiation reveals colorectal cancer biomarker and associated receptor alterations. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 2505. doi:10.1158/1538-7445.AM2014-2505
Somatic mutational landscape of AML with inv(16) or t(8;21) identifies patterns of clonal evolution in relapse leukemia
Authors: R Sood, N F Hansen, F X Donovan, B Carrington, D Bucci, B Maskeri, A Young, N S Trivedi, J Kohlschmidt, R M Stone, M A Caligiuri, S C Chandrasekharappa, G Marcucci, J C Mullikin, C D Bloomfield, P Liu
Journal: Leukemia (2015)
Abstract P230: Measures of Glycaemia (Fasting and 2 hr Glucose, Glycosylated Haemoglobin) in Relation to Incident Vascular Disease in Non-diabetic Adults
Authors: Patricia A Metcalf, Campbell Kyle, Tim Kenealy, Tania Riddell, Carol Chelimo, Sue Wells, Rod Jackson
Journal: Circulation (2014)

Introduction: Glycosylated haemoglobin (HbA 1c ) has recently been accepted for diagnosing diabetes in New Zealand. A 2 hour 75g oral glucose test was used previously and remains an alternative for diagnosis. Hypothesis: We assessed the hypothesis that HbA 1c would do at least as well as fasting and 2 hour glucose levels for predicting vascular events. Methods: Baseline data from a primary care cardiovascular disease (CVD) risk register of approximately 220,000 patients were prospectively linked to hospitalization, mortality and lab test data. There were 21,720 patients without a history of diabetes or CVD who had an HbA 1c and oral glucose tolerance test. We compared the prognostic value of HbA 1c and fasting and CVD or all-cause mortality using Cox proportional hazards regression. Results: The median follow-up time was 5 years (range 0 to 11). For HbA 1c values of less than 5.0%, 5.0 to less than 5.5%, 5.5 to less than 6.0%, 6.0 to less than 6.5%, and 6.5% or greater, the adjusted (age, gender and ethnicity) hazard ratios (with 95% confidence intervals) for diabetic hospitalisations were respectively: 1.45 (0.81-2.45), 1.00 (reference), 1.27 (1.01-1.63), 2.34 (1.88 -2.95), and 6.31 (5.10-7.94), respectively. Baseline HbA 1c was also related to risk of renal complications and retinopathy. For CVD, the hazard ratios (HR’s) were 0.95 (0.51-1.62), 1.00 (reference), 1.16 (0.95-1.42), 1.19 (0.98-1.46), and 1.32 (1.09-1.61), respectively. All associations remained significant after adjustment for the baseline fasting and 2 hour glucose levels. No HR’s were significant for all-cause mortality after adjusting for ethnicity. The associations between fasting glucose levels and the risk of CVD or death from any cause were not significant in models with adjustment for age, gender and ethnicity as well as HbA 1c . The association between the 2 hour glucose levels and the risk of diabetes was significant, but attenuated, in the model with adjustment for age, gender and ethnicity as well as HbA 1c . Conclusions: In conclusion, in people with no diabetes and no CVD, baseline HbA 1c was associated with subsequent diabetes, CVD, diabetic renal complications and retinopathy. HbA 1c was more strongly associated with these vascular complications than were fasting glucose and 2-hour glucose.
Large and ongoing outbreak of haemolytic uraemic syndrome, Germany, May 2011
Authors: C Frank, M S Faber, M Askar, H Bernard, A Fruth, A Gilsdorf, M Höhle, H Karch, G Krause, R Prager, A Spode, K Stark, D Werber
Journal: Eurosurveillance (2011)

Since early May 2011, an increased incidence of haemolytic uraemic syndrome (HUS) and bloody diarrhoea related to infections with Shiga toxin-producing Escherichia coli (STEC) has been observed in Germany, with most cases in the north of the country. Cases reported from other European countries had travelled to this area. First results of a case–control study conducted in Hamburg suggest an association between the occurrence of disease and the consumption of raw tomatoes, cucumber and leaf salad.
Major Outcomes in Moderately Hypercholesterolemic, Hypertensive Patients Randomized to Pravastatin vs Usual Care: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT-LLT)
Authors: Curt D. Furberg, Jackson T. Wright, Barry R. Davis, Jeffrey A. Cutler, Michael Alderman, Henry Black, William Cushman, Richard Grimm, L. Julian Haywood, Frans Leenen
Journal: JAMA (2002)

ContextStudies have demonstrated that statins administered to individuals with risk factors for coronary heart disease (CHD) reduce CHD events. However, many of these studies were too small to assess all-cause mortality or outcomes in important subgroups.ObjectiveTo determine whether pravastatin compared with usual care reduces all-cause mortality in older, moderately hypercholesterolemic, hypertensive participants with at least 1 additional CHD risk factor.Design and SettingMulticenter (513 primarily community-based North American clinical centers), randomized, nonblinded trial conducted from 1994 through March 2002 in a subset of participants from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT).ParticipantsAmbulatory persons (n = 10 355), aged 55 years or older, with low-density lipoprotein cholesterol (LDL-C) of 120 to 189 mg/dL (100 to 129 mg/dL if known CHD) and triglycerides lower than 350 mg/dL, were randomized to pravastatin (n = 5170) or to usual care (n = 5185). Baseline mean total cholesterol was 224 mg/dL; LDL-C, 146 mg/dL; high-density lipoprotein cholesterol, 48 mg/dL; and triglycerides, 152 mg/dL. Mean age was 66 years, 49% were women, 38% black and 23% Hispanic, 14% had a history of CHD, and 35% had type 2 diabetes.InterventionPravastatin, 40 mg/d, vs usual care.Main Outcome MeasuresThe primary outcome was all-cause mortality, with follow-up for up to 8 years. Secondary outcomes included nonfatal myocardial infarction or fatal CHD (CHD events) combined, cause-specific mortality, and cancer.ResultsMean follow-up was 4.8 years. During the trial, 32% of usual care participants with and 29% without CHD started taking lipid-lowering drugs. At year 4, total cholesterol levels were reduced by 17% with pravastatin vs 8% with usual care; among the random sample who had LDL-C levels assessed, levels were reduced by 28% with pravastatin vs 11% with usual care. All-cause mortality was similar for the 2 groups (relative risk [RR], 0.99; 95% confidence interval [CI], 0.89-1.11; P = .88), with 6-year mortality rates of 14.9% for pravastatin vs 15.3% with usual care. CHD event rates were not significantly different between the groups (RR, 0.91; 95% CI, 0.79-1.04; P = .16), with 6-year CHD event rates of 9.3% for pravastatin and 10.4% for usual care.ConclusionsPravastatin did not reduce either all-cause mortality or CHD significantly when compared with usual care in older participants with well-controlled hypertension and moderately elevated LDL-C. The results may be due to the modest differential in total cholesterol (9.6%) and LDL-C (16.7%) between pravastatin and usual care compared with prior statin trials supporting cardiovascular disease prevention.
Abstract 80: Role Of Vascular Beta 2-adrenoceptors In Endotoxemic Shock
Authors: Bertrand Rozec, Thuy Tran Quan, Emmanuelle Lavazais-Blancou, Leslie Audigane, Yvonnick Blanloeil, Chantal Gauthier-Erfanian
Journal: Circulation (2007)

Although it is known that during endotoxemic shock the use of β-adrenergic agonists can improve organs blood flow independently of cardiac output increase, there is no study in the literature conce...
Pravastatin and Coronary Heart Disease
Authors: Gerd Assmann, Helmut Schulte, Paul Cullen
Journal: Circulation (1998)

The article by Kluijtmans and colleagues 1 (Circulation, October 21, 1997) adds to the growing literature on the relationship between the common thermolabile variant of methylenetetrahydrofolate reductase (MTHFR) and risk of vascular disease.In an angiographically assessed cohort of subjects with coronary artery disease (CAD) participating in a statin regression trial (RE-GRESS), significantly increased homocysteine concentrations were found in subjects homozygous (ϩ/ϩ) or heterozygous (ϩ/Ϫ) for the thermolabile variant compared with those carrying only the normal variant (Ϫ/Ϫ).Median levels were 2.8 and 0.8 mol/L higher in the ϩ/ϩ and ϩ/Ϫ subjects, respectively.Compared with population-based controls, there was trend toward higher risk of CAD in subjects carrying the thermolabile variant, but this did not reach significance (OR for ϩ/ϩ versus Ϫ/Ϫ: 1.21 [0.87 to 1.68]; ϩ/Ϫ versus Ϫ/Ϫ: 1.14 [0.94 to 1.38]).However, when the results were combined with those of 6 other studies, including our own, 2 in a meta-analysis, there was a significant increase in relative risk in subjects with the ϩ/ϩ genotype (OR, 1.22; 95% CI, 1.10 to 1.47).The data of Kluijtmans et al in a large cohort of wellcharacterized CAD patients are welcome.However, I am concerned by their meta-analysis.They have pooled together data from studies that have examined different phenotypes.For example, in our study, 2 we recruited subjects with myocardial infarction.Although there is, of course, a relationship between angiographic CAD and myocardial infarction, the 2 are not synonymous, and each has distinct determinants.This is likely to extend to genetic causes.Indeed, analysis of different phenotypes may explain at least some of the discrepancies that have been reported not only in relation to the thermolabile MTHFR mutation but also to other genetic factors.Meta-analysis, even when restricted to a single phenotype, has several well-recognized limitations. 3 When added to by heterogeneity in the phenotype, its validity is highly questionable.The meta-analysis carried out by Kluijtmans et al adds little to their primary data.Although positive, it should not be interpreted as strong evidence in support of a role for the MTHFR thermolabile mutation as a determinant of coronary risk.
Impaired lymphangiogenesis due to excess vascular endothelial growth factor-D/Flt-4 signalling in the skin of patients with systemic sclerosis
Authors: N. Honda, M. Jinnin, I. Kajihara, T. Makino, S. Fukushima, H. Ihn
Journal: British Journal of Dermatology (2010)

Vascular abnormalities are one of the primary pathological components of systemic sclerosis (SSc). However, it has not been determined if there are also abnormalities in the formation of lymphatic vessels in SSc.To evaluate lymphangiogenic activity in SSc skin.The numbers of D2-40-positive lymphatic vessels in skin specimens from healthy control subjects and patients with SSc were counted and compared. Quantitative real-time polymerase chain reaction (PCR) was performed to determine mRNA levels of vascular endothelial growth factor (VEGF)-D and Flt-4 (fms-related tyrosine kinase 4, VEGFR-3, one of the receptors for VEGF-D) in the skin. Serum VEGF-D levels were measured with specific enzyme-linked immunosorbent assays. RESULTSZ: The number of lymphatic vessels in patients with SSc was significantly decreased compared with healthy control subjects. Mean relative transcript levels of FIGF (VEGF-D) and FLT4 (Flt-4) in skin tissue from patients with SSc were significantly increased compared with healthy control subjects. By the analysis of the association between serum VEGF-D levels and the clinical or laboratory features, we found that patients with SSc with higher serum VEGF-D levels more frequently have skin ulcers than those with normal VEGF-D levels.A systemic increase of VEGF-D, as well as local overexpression of FIGF and FLT4, may be the cause of disturbed lymphangiogenesis in SSc skin and play a role in the pathogenesis of SSc. We showed the possibility that regulation of VEGF-D/Flt-4 signalling could lead to new treatment of skin ulcers in SSc by controlling the formation of lymphatic vessels.