tbuckley/cabot-search huggingface dataset:
A prospective study of injuries to elite Australian rugby union players
Authors: A Bathgate, J P Best, G Craig, M Jamieson
Journal: British Journal of Sports Medicine (2002)

To assess injury patterns and incidence in the Australian Wallabies rugby union players from 1994 to 2000. To compare these patterns and rates with those seen at other levels of play, and to see how they have changed since the beginning of the professional era.Prospective data were recorded from 1994 to 2000. All injuries to Australian Wallabies rugby union players were recorded by the team doctor. An injury was defined as one that forced a player to either leave the field or miss a subsequent game.A total of 143 injuries were recorded from 91 matches. The overall injury rate was 69/1000 player hours of game play. The injury rates in the periods before (1994-1995) and after (1996-2000) the start of the professional era were 47/1000 player hours and 74/1000 player hours respectively. The lock was the most injured forward, and the number 10 the most injured back. Most injuries were soft tissue, closed injuries (55%), with the head being the most commonly injured region (25.1%). The phase of play responsible for most injuries was the tackle (58.7%). Injuries were more likely to occur in the second half of the game, specifically the third quarter (40%). The vast majority of injuries were acute (90%), with the remainder being either chronic or recurrent.Injury rate increases at higher levels of play in rugby union. Injury rates have increased in the professional era. Most injuries are now seen in the third quarter of the game, a finding that may reflect new substitution laws. There is a need for standardised collection of injury data in rugby union.
Pulmonary embolism due to cardiac hydatid disease: Unusual complication of hydatid cyst
Authors: Walid Feki, Besma Dhahri, Hichem Aouina, Jamel El Ghoul, Manel Hadiji, Jihen Ben Ammar, Saloua Azzabi, M. Ali Baccar, Leila El Gharbi, Hend Bouacha
Journal: European Respiratory Journal (2011)

Hydatid disease represents the most important parasitic infection in Tunisia with annual incidence of 15 per 100000 inhabitant. Neverthless, hydatid pulmonary embolism is an uncommon condition. We report a case of primary cardiac hydatid cyst in which hydatid materials caused recurrent embolizations in pulmonary arteries and pulmonary parenchyma.

Case presentation: A nineteen-year-old girl, was admitted to Charles Nicolle hospital reporting eight months history of anorexia, asthenia and cough.The physical examination results were normal. Chest radiography revealed a convex middle arch and multiple bilateral homogenous circular opacities. Electrocardiographic finding was a right ventricular hypertrophy. Echocardiography showed a cystic mass developed from the lower and the side right ventricular wall, which restrain tricuspid orifice with a 38 mmhg mean PAP. A CT chest-abdominal scan examination revealed the presence of an hypodense cystic lesion of 4 cm in the right ventricle with right pulmonary artery embolism, and multiple bilateral parenchymatous excavated nodule associated to a calcificated cystic lesion in VII segment of the liver. Serologic test results for echinococcus by means of an enzyme-linked immunosorbent assay and an indirect haemagglutination test were positive. Cysts were punctured, aspirated, and resected. Upon discharge from the hospital, patient was prescribed 10mg/kg/day of albendazole.

Conclusion: Hydatid pulmonary embolism is one of the inescapable complication of left heart Echinococcosis. It is rare but serious. There is no consensus of treatment. Early diagnosis is essential because delayed treatment increases the morbidity and mortality rates.
Arthroscopic surgery for degenerative knee
Authors: A. Carr
Journal: BMJ (2015)

Overused, ineffective, and potentially harmful

The most frequent indication for knee arthroscopy is degenerative joint disease in middle aged and older patients. Each year, more than 700 000 knee arthroscopies are done in the United States and 150 000 in the United Kingdom.1 Magnetic resonance imaging evidence of meniscal abnormality, osteophytes, cartilage damage, and bone marrow lesions is often present. All these imaging abnormalities are common in the general population and are often asymptomatic.2 The evidence base for arthroscopic surgery is known to be weak, and a pressing need exists for more high quality multicentre randomised controlled trials, systematic reviews, and meta-analyses to inform clinicians and improve care for patients.3 Researchers have already reported that trials of arthroscopic surgery find no benefit over control interventions ranging from exercises to placebo surgery.4 

A linked paper by Thorlund and colleagues (doi:10.1136/bmj.h2747) adds substantially to the debate by systematically reviewing all the evidence on the benefits and harms of arthroscopic knee surgery for middle aged and older adults with knee pain and degenerative knee disease.5 The authors report that the small benefit seen after arthroscopic surgery of the …
Hepatitis B reactivation in HBsAg-negative/HBcAb-positive allogeneic haematopoietic stem cell transplant recipients: risk factors and outcome
Authors: M. Mikulska, L. Nicolini, A. Signori, G. Rivoli, V. Del Bono, A.M. Raiola, C. Di Grazia, A. Dominietto, R. Varaldo, A. Ghiso, A. Bacigalupo, C. Viscoli
Journal: Clinical Microbiology and Infection (2014)
Trends in the asthma hospitalization rate in the Spanish pediatric population
Authors: Javier de Miguel Díez, Julio Vargas Espinal, Jorge Chancafe Morgan, Valentin Hernandez Barrera, Rodrigo Jiménez García, Luis Puente Maestu, Pilar Carrasco Garrido
Journal: European Respiratory Journal (2013)

Objective: To assess the changes in incidence, length of stay (LOS) and costs, of patients hospitalized for asthma exacerbations (AE) between 2002 and 2010.

Methods: We included all the pediatric patients (younger than 15 years old) hospitalized for AE between 2002 and 2010 (ICD9-CM codes 493.0x-493.9x ). The data were collected from the National Hospital Discharge Database (entire population). We compared the incidence, LOS and costs per patient of this population in two points in the time 2002 and 2010.

Results: We included a total of 12,038 patients. Overall crude incidence decreased from 20.5 to 18.7 AE per 100.000 inhabitants from 2002 to 2010 (p<0.05). There was no difference for sex. The mean LOS was 3.71 (SD 2.28) days in 2001 and decreased progressively to 3.16 (SD 2.11) in 2010 (p<0.05). During the study period, the mean cost per patient decreased from 1558.53 (SD 443.63) to 1378.41 (SD 472.71) euros (p<0.05).

Conclusion: Our results suggest a decrease in the incidence of hospital admissions for AE with concomitant decrease in LOS in this population. The mean cost per patient also decreased significantly. Better primary care management of disease may explain the improvement in the incidence and outcomes.
Current preventive strategies and management of Epstein–Barr virus-related post-transplant lymphoproliferative disease in solid organ transplantation in Europe. Results of the ESGICH Questionnaire-based Cross-sectional Survey
Authors: R. San-Juan, O. Manuel, H.H. Hirsch, M. Fernández-Ruiz, F. López-Medrano, P. Comoli, S. Caillard, P. Grossi, J.M. Aguado
Journal: Clinical Microbiology and Infection (2015)
Evaluation of cognitive dysfunction using the cognitive failures questionnaire (CFQ), driving incidents and driving simulator (MiniUoLDS) outcome in obstructive sleep apnoea syndrome (OSAS) patients and controls
Authors: Akshay Dwarakanath, Dipansu Ghosh, Samantha Jamson, Mark Elliott
Journal: European Respiratory Journal (2014)

Introduction   A range of cognitive deficits have been identified in OSAS patients.The CFQ is a measure of self-reported deficits in the completion of simple everyday tasks that includes various components such as failures in attention,memory,perception and motor functions.We hypothesised that OSAS patients exhibit worse cognitive dysfunction as compared to controls using the CFQ and hence have more driving incidents and perform worse on the MiniUoLDS.   Methods   154(Age-53+/-12,ESS-14+/-7,ODI-40+/-26) untreated OSAS patients and 105 controls (Age-55 +/-15,ESS-4+/-3) were included.All completed a questionnaire that included previous driving incidents in the last 1 year,Epworth sleepiness score (ESS) and the CFQ.All performed a 90km motorway driving simulation.   Results   There was a significant difference in the total CFQ score between patients and the controls (37 ± 20 & 28 ± 12, P   Conclusion   As compared to controls,OSAS patients have a significant higher total CFQ score and also a significant higher score of all the components of CFQ.OSAS patients with higher CFQ score reported increased driving incidents in the last one year.CFQ score does not predict MiniUoLDS outcome.The CFQ is easy to complete and our data suggests it may be a useful tool for assessing cognitive dysfunction in OSAS.
Electronic auscultation of the lungs in children with asthma
Authors: Elena Stezhkina, Tatiana Filimonova, Galina Sharowskaya, Andrey Dmitriev
Journal: European Respiratory Journal (2011)

Aim:  The aim of this study was to determine the quantitative characteristics of sounds by electronic auscultation in children with asthma.   Materials and methods:  112 children with moderate and severe persistent asthma and 41 healthy child, the control group, aged 7-18 years were included in this study. Sound phenomens recorded on the chest with an electret microphone SAFA (Korea) twice: at admission and on the third day of treatment. Data processing was carried out using Audacity 1.3 audio editing and Adobe Audition 1.5.   Results:  The asthmatic children respirophonogram9s curve didn9t show a smooth amplitude decrease in frequencies over 300-1200 Hz, had the persistence of the peaks in the range of more than 1100 Hz, the sawtooth shape of the curve. Sound characteristics do not depend on sex, age, level of physical development of children.  After treatment we noted the decrease of the respirofonogram9s curve in amplitude at frequencies exceeding 500 Hz, with preservation of low-amplitude peaks in the range of high frequency (1200 Hz). Thus, the air flow becomes less turbulent and severity of bronchial obstruction is reduced. Correlations between the parameters of respiratory sounds and spirometry and peak flow not revealed.   Conclusion:  Quantitative characteristic respiratory sounds by the electronic auscultation allows to objectively establish the presence of obstruction in children.
Differential coreceptor expression allows for independent evolution of non–syncytium-inducing and syncytium-inducing HIV-1
Authors: Ronald P. van Rij, Hetty Blaak, Janny A. Visser, Margreet Brouwer, Ronald Rientsma, Silvia Broersen, Ana-Maria de Roda Husman, Hanneke Schuitemaker
Journal: Journal of Clinical Investigation (2000)

We demonstrated previously that CD45RA+ CD4+ T cells are infected primarily by syncytium-inducing (SI) HIV-1 variants, whereas CD45RO+ CD4+ T cells harbor both non-SI (NSI) and SI HIV-1 variants. Here, we studied evolution of tropism for CD45RA+ and CD45RO+ CD4+ cells, coreceptor usage, and molecular phylogeny of coexisting NSI and SI HIV-1 clones that were isolated from four patients in the period spanning SI conversion. NSI variants were CCR5-restricted and could be isolated throughout infection from CD45RO+ CD4+ cells. SI variants seemed to evolve in CD45RO+ CD4+ cells, but, in time, SI HIV-1 infection of CD45RA+ CD4+ cells equaled infection of CD45RO+ CD4+ cells. In parallel with this shift, SI HIV-1 variants first used both coreceptors CCR5 and CXCR4, but eventually lost the ability to use CCR5. Phylogenetically, NSI and SI HIV-1 populations diverged over time. We observed a differential expression of HIV-1 coreceptors within CD45RA+ and CD45RO+ cells, which allowed us to isolate virus from purified CCR5+ CXCR4– and CCR5– CXCR4+ CD4+ cells. The CCR5+ subset was exclusively infected by CCR5-dependent HIV-1 clones, whereas SI clones were preferentially isolated from the CXCR4+ subset. The differential expression of HIV-1 coreceptors provides distinct cellular niches for NSI and SI HIV-1, contributing to their coexistence and independent evolutionary pathways.
Impact of Young Age on Outcome in Patients With Ductal Carcinoma-In-Situ Treated With Breast-Conserving Therapy
Authors: Frank A. Vicini, Larry L. Kestin, Neal S. Goldstein, Peter Y. Chen, Jane Pettinga, Robert C. Frazier, Alvaro A. Martinez
Journal: Journal of Clinical Oncology (2000)

We reviewed our institution's experience treating patients with ductal carcinoma-in-situ (DCIS) with breast-conserving therapy (BCT) to determine the impact of patient age on outcome.From 1980 to 1993, 146 patients were treated with BCT for DCIS. All patients underwent excisional biopsy, and 64% underwent re-excision. All patients received whole-breast irradiation to a median dose of 45 Gy. Ninety-four percent of patients received a boost to the tumor bed, for a median total dose of 60.4 Gy. All slides on every patient were reviewed by one pathologist. The median follow-up period was 7.2 years.Seventeen patients developed an ipsilateral local recurrence, for 5- and 10-year actuarial rates of 10.2% and 12.4%, respectively. The 10-year rate of ipsilateral failure was 26.1% in patients younger than 45 years of age versus 8.6% in older patients (P =.03). On multivariate analysis, young age was independently associated with recurrence of the index lesion (true recurrence/marginal miss ¿TR/MM failures), regardless of how it was analyzed (eg, < 45 years of age or as a continuous variable). In addition, young patients had a dramatically higher 10-year rate of invasive TR/MM failures (19.9% v 3.2%). In a separate multivariate analysis for the development of invasive TR/MM failures, only patient age and predominant nuclear grade were independently associated with recurrence. The relationship between excision volume and outcome was analyzed in the 95 patients who underwent re-excision. The 5-year actuarial rate of TR/MM failure was significantly worse only in young patients with smaller (< 40 mL) re-excision volumes (33.3% v 9.1%; P =.02). In a separate multivariate analysis of only these 95 patients (25 of whom were < 45 years of age), the volume of re-excision had the strongest association with outcome (P =.05). Patient age was no longer associated with local recurrence.These findings suggest that young patients with DCIS have a significantly greater risk of local recurrence after BCT that is independent of other previously defined risk factors. Our data also suggest that the extent of resection may in part be related to the less optimal results that are observed in these patients.
Lesson of the week: Man's best friend: life threatening sepsis after minor dog bite
Authors: D J Mellor, S. Bhandari, K Kerr, A R Bodenham
Journal: BMJ (1997)

Molecular genetics has greatly increased the understanding of diseases in which there is a single gene defect such as cystic fibrosis.Discovering the gene responsible and its function not only helps determine the pathogenesis of the disease but also offers a possible treatment-gene therapy.Polygenic disorders such as diabetes may soon yield their secrets to the same approach.Animal models of genetic diseases are proving useful research tools, and transgenesis has made xenografting possible.Furthermore, antisense technology allows specific inhibition of undesirably overexpressed genes such as those driving unwanted vascular cell proliferation and restenosis after angioplasty.The completion of the human genome project should make the search for "disease" genes much quicker and will increase still further the importance of these gene based approaches toward diseases.
Prospective phase II study of capecitabine and temozolomide (CAPTEM) for progressive, moderately, and well-differentiated metastatic neuroendocrine tumors.
Authors: Robert Lance Fine, Anthony Paul Gulati, Dawn Tsushima, Kelley B. Mowatt, Anna Oprescu, Jeffrey N. Bruce, John A. Chabot
Journal: Journal of Clinical Oncology (2014)

179 Background: We found in our lab that capecitabine (CAP), the prodrug of 5-FU, and temozolomide (TEM) were synergistic in inducing apoptosis in BON neuroendocrine tumor (NET) cell lines. We were the first to report in 2004 the use and mechanism of action of CAP and TEM (CAPTEM) in well differentiated NETs with promising results. Here we describe the interim analysis of an ongoing Phase II trial. Methods: 28 patients with metastatic well-moderately differentiated NET (ki-67 ≤20%) who had shown progression only on 60mg Sandostatin LAR (if octreotide scan positive) were treated with the following regimen: CAP 1,500mg/m 2 /day (PO divided BID, maximum 2,500 mg/day) on d1-14, and TEM 150-200mg/m 2 /day (PO divided BID, lower dose for patients who had prior chemotherapy or extensive radiation) on d10-14, with the next two weeks off, in a 28 day cycle. Primary objective was RR based upon RECIST, and secondary objectives included PFS, OS (from time of initiation of therapy), and toxicity evaluation. Other inclusion criteria were: age &lt;80, ECOG PS 0-2, and adequate hematologic, renal, and liver function, and failure on high dose Sandostatin LAR. Results: 28 of 38 planned patients were enrolled with various NET subtypes (table). Overall RR was 43% (11% CR) and SD rate was 54%, with clinical benefit in 97%. ORR was 41% in carcinoid tumors. Ongoing mPFS is &gt;20mo for all subtypes with 18/28 (64%) having progressed at this time. Twelve of 28 had died at this analysis with ongoing mOS of &gt;25.3mo. The most common G3/4 toxicities were lymphopenia (32%), hyperglycemia (15%, unlikely related), thrombocytopenia (3%), and diarrhea (3%). No hospitalizations, opportunistic infections, or deaths occurred from CAPTEM. Conclusions: CAPTEM is an effective treatment for patients with progressive NET who failed high dose octreotide, with high PR and SD rates in carcinoids and insulinomas. The ongoing PFS in pancreatic NETs (&gt;18.2 mo) is 150% greater than reported with everolimus and sutent. Clinical trial information: NCT00869050. [Table: see text]
Medical Journal of Australia editor sacked over opposition to Elsevier outsourcing
Authors: M. Mcinerney
Journal: BMJ (2015)

<b>Background:</b> We sought to estimate the rate of initiation of insulin therapy among elderly patients using oral anti-diabetes drugs and to identify the factors associated with this initiation. <b>Methods:</b> We conducted a population-based cohort study involving people aged 66 or more years who were newly dispensed an oral antidiabetes drug. Individuals who had received acarbose or a thiazolidinedione were excluded. The rate of insulin initiation was calculated by use of the Kaplan–Meier method. Factors associated with insulin initiation were identified by multivariable Cox regression analyses. <b>Results:</b> In this cohort of 69 674 new users of oral antidiabetes drugs, insulin was initiated at rate of 9.7 cases per 1000 patient-years. Patients who had initially received an insulin secretagogue (rather than metformin), who were prescribed an oral antidiabetes drug by an endocrinologist or an internist, who received higher initial doses of an oral antidiabetes drug, who received oral corticosteroids, used glucometer strips, or were admitted to hospital in the year before initiation of oral antidiabetes therapy, or who received 16 or more medications were more likely than those without these characteristics to have insulin therapy initiated. In contrast, patients who received thiazides or who used up to 12 medications (v. none) were less likely to have insulin therapy initiated. <b>Interpretation:</b> Several factors related to drugs and health services are associated with the initiation of insulin therapy in elderly patients receiving oral antidiabetes drugs. It is unclear whether these factors predict secondary failure of oral antidiabetes drugs or instead reflect better management of type 2 diabetes.
Factors associated with high levels of exhaled NO in children using asthma medication
Authors: Susanne Vijverberg, Ellen Koster, Leo Koenderman, Dirkje Postma, Gerard Koppelman, Kors van der Ent, Jan Raaijmakers, Anke-Hilse Maitland-van der Zee
Journal: European Respiratory Journal (2011)

Background:  A high fractional nitric oxide concentration in exhaled breath (FeNO) is thought to be a marker of ongoing airway inflammation and may reflect poor asthma control.   Objectives:  To study factors associated with high FeNO in children using asthma medication.   Methods:  Our study population consists of 602 children (age 4-12 years) who used asthma medication in the past year and participated in the PACMAN (Pharmacogenetics of Asthma medication in Children: Medication with ANti-inflammatory effects)-cohort study. FeNO was measured using an electrochemical hand-held device (Niox Mino, Aerocrine, Sweden). Data on respiratory symptoms, medication use, therapy adherence and environmental factors were collected using a questionnaire. Asthma control was defined using the Asthma Control Questionnaire (ACQ). Children with high FeNO (>25 ppb) were compared to children with normal FeNO (5-25 pbb). Logistic regression analysis was used to study factors associated with high FeNO.   Results:  FeNO could be measured in 501 children (83%); FeNO was high in 134 children (27%). Children with high FeNO were older than children with normal FeNO (mean age: 9.8 vs 8.7 years, p   Conclusions:  In our cohort of children using asthma medication, high FeNO is associated with higher age, lower adherence and less well-controlled asthma at population level. Further research is necessary to assess the value of FeNO for the individual patient.
Effects of a complication of non-tuberculous mycobacterium on interstitial pneumonia
Authors: Hiroyuki Kamiya, Soichiro Ikushima, Keisuke Kondo, Kota Satake, Minoru Inomata, Atsuko Moriya, Tsunehiro Ando
Journal: European Respiratory Journal (2012)

Background  It is widely recognized that non-tuberculous mycobacteria complicate underlying pulmonary diseases. Interstitial pneumonia, which is characterized by pulmonary fibrotic changes with various potential etiologies, will be treated by immunosuppressants, and can be complicated by non-tuberculous mycobacteria. However, the effect of a complication of non-tuberculous mycobacteria on the clinical outcomes of interstitial pneumonia has been little addressed.  Methods  Patients, who were diagnosed as having interstitial pneumonia and showed at least one isolation of non-tuberculous mycobacterium from respiratory samples, were difined as cases, while patients with a diagnosis of interstitial pneumonia and no isolation of non-tubeculous mycobacterium were screened as matched-controls.  Results  A total of twelve and twenty four patients were identified as cases and controls, respectively. The median age of cases was 64.0 years, while that of controls was 58.0 years, and the distribution of sex was the same in both groups as being 66.7% of male patients. 58.3% of cases and 29.2% of controls showed UIP pattern, which was not significantly different. Both groups were treated similarly and 75.0% of patients received some immunosuppressants. The median survival of cases was 9 years after the diagnosis of interstitial pneumonia was made, which was not significantly different from that of controls.  Conclusion  Non-tuberculous mycobacterium was tended to be complicated in interstitial pneumonia with UIP pattern, however, no significant effect of a complication of non-tuberculous mycobacterium on the survival of patients with interstitial pneumonia was demonstrated.