tbuckley/cabot-search huggingface dataset:
Learning from our patients and each other
Authors: T. Richards
Journal: BMJ (2003)

Clinical Review p 588 

Picking over the bones of case histories can be a highly effective way of learning. 1 2 Doctors have a common interest in patients and their stories, and they provide a good way of stimulating problem based learning.3–5 With this in mind, we are starting a new interactive case based series with the case history of “Ruth,” a 66 year old housewife who presented to her general practitioner with a rash. Comments on her initial presentation, which appears in the Clinical Review section (p 588), are invited via the rapid responses feature on bmj.com.

This is the first in …
DNA vaccination against macrophage migration inhibitory factor improves atopic dermatitis in murine models
Authors: Asuka Hamasaka, Riichiro Abe, Yoshikazu Koyama, Naoya Yoshioka, Yasuyuki Fujita, Daichi Hoshina, Mikako Sasaki, Tsutomu Hirasawa, Shin Onodera, Shigeki Ohshima, Lin Leng, Richard Bucala, Jun Nishihira, Tadamichi Shimizu, Hiroshi Shimizu
Journal: Journal of Allergy and Clinical Immunology (2009)
In praise of informed scepticism
Authors: F. Godlee
Journal: BMJ (2013)

Earlier this year, guidelines from three respected US professional societies advised doctors to give alteplase to patients with acute stroke. The recommendation was based on what the guidelines’ authors considered grade A evidence. Yet as Jeanne Lenzer reports (doi:10.1136/bmj.f3830), surveys show that many if not most emergency physicians are sceptical of the benefits and concerned about the harms of alteplase. The published evidence shows reductions in disability but not in mortality, with only two of the 12 randomised trials showing benefit and five having been terminated early because of lack of benefit, higher mortality, and significant increases in brain haemorrhage.

So how did this grade A recommendation occur? Lenzer …
American and European recommendations for screening mammography in younger women: a cultural divide?
Authors: I Jatoi, M Baum
Journal: BMJ (1993)

The American Cancer Society advocates mammography screening for all women from age 40, whereas in Europe it is not recommended for women below the age of 50. Randomised prospective studies have failed to show a significant benefit from screening women aged under 50 and five potentially harmful effects of screening should be considered: lead time, overdiagnosis, radiation exposure, false positive results, and cost. Younger women must be properly informed about the potential for harm as well as for benefit before screening.
Abstract 12436: Nox2-Mediated Arterial Dysfunction in Smokers: Effect of Dark Chocolate
Authors: Lorenzo Loffredo, Roberto Carnevale, Ludovica Perri, Elisa Catasca, Teresa Augelletti, Roberto Cangemi, Fabiana Albanese, Maria Michela Palumbo, Cristina Nocella, Pasquale Pignatelli, Francesco Violi
Journal: Circulation (2011)

Objectives: Cocoa seems to exert arterial dilation via oxidative stress inhibition but the mechanism is still unclear. We investigated whether in smokers dark chocolate elicits arterial dilation vi...
FDG-PET imaging for the evaluation of antiglioma agents in a rat model
Authors: Sarah Assadian, Antonio Aliaga, Rolando F. Del Maestro, Alan C. Evans, Barry J. Bedell
Journal: Neuro-Oncology (2008)

The increasing development of novel anticancer agents demands parallel advances in the methods used to rapidly assess their therapeutic efficacy (TE) in the preclinical phase. We evaluated the ability of small-animal PET, using the (18)F-fluoro-deoxy-D-glucose (FDG) radiotracer, to predict the TE of a number of anticancer agents in the rat C6 glioma model following 3 days of treatment. Semi-quantitative measurements of changes in FDG uptake during the course of treatment (standardized uptake value response [SUV(r)]) were found to be significantly lower in tumors treated with the hypoxia-inducible factor-1alpha inhibitor YC-1 (15 mg/kg) than in tumors in the control group. No significant SUV(r) change was observed following a similar 3-day regimen with the proapoptotic agent NS1619 (20 microg/kg), the combination of YC-1 and NS1619, or the alkylating agent temozolomide (7.5 mg/kg). Quantitative immunohistochemical studies demonstrated significantly lower levels of glucose transporter-1 (GLUT-1) expression in the YC-1-treated tumors, thereby correlating with the low SUV(r) observed in this group. The ability of SUV(r) to predict gold-standard outcomes of TE was further validated as YC-1-treated tumors had decreased volumes compared to control tumors. As such, we successfully demonstrated the ability of FDG-PET to rapidly determine the TE of novel agents for the treatment of glioma in the preclinical phase of evaluation.
Concomitant Hyperthyroidism in Patients With Thyroid Carcinoma and the Effects of Iodine Supplementation in an Iodine-Deficient Area
Authors: Özgür Ömür, Bülent Yazc, Ayegül Akgün, Zehra Özcan, Mahir Akyldz, Murat Argon, Hayal Özklç
Journal: Clinical Nuclear Medicine (2008)

Objectives of this study were to investigate the occurrence and aggressiveness of differentiated thyroid carcinoma (DTC) in patients with hyperthyroidism and to explore the influence of the changes in dietary iodine intake on the association of hyperthyroidism and DTC. Clinical records of 1,800 patients with DTC were reviewed. The characteristics of DTC cases with and without thyrotoxicosis and their thyroid tumors were comparatively assessed.In the current series, 76 patients (4.2%) presented with hyperthyroidism before thyroid surgery. The most common type of goiter among 76 patients was toxic multinodular goiter. Presence of lymph node metastasis and recurrence was only observed in patients with toxic diffuse goiter. When DTC cases with and without thyrotoxicosis were compared irrespective of the type of goiter, aggressiveness of thyroid carcinoma was not higher in the thyrotoxic group. Hyperthyroidism and thyroid carcinoma coexisted in 3.3% and 4.7% in cases diagnosed before and after national iodine supplementation program, respectively (P = 0.04). Clinical course of the disease was not different in the diagnosis of these cases. As a result of no significant difference in complete remission ratio, we conclude that there is no need for a different DTC treatment protocol in cases with coexisting hyperthyroidism.
Specific MAIT cell behaviour among innate-like T lymphocytes in critically ill patients with severe infections
Authors: David Grimaldi, Lionel Le Bourhis, Bertrand Sauneuf, Agnès Dechartres, Christophe Rousseau, Fatah Ouaaz, Maud Milder, Delphine Louis, Jean-Daniel Chiche, Jean-Paul Mira, Olivier Lantz, Frédéric Pène
Journal: Intensive Care Medicine (2013)
GP who sent daughter to Spain for late abortion claims she did nothing wrong
Authors: C. Dyer
Journal: BMJ (2010)

A GP flew her teenage daughter from the United Kingdom to Spain for a late abortion after she was turned down by a British clinic, a General Medical Council panel heard this week.

Saroj Adlakha, who ran the Shilpa medical centre in Kings Heath, Birmingham, paid €3200 (£2900; $4650) for her 18 year old daughter to have the abortion at the Ginemedex clinic in Barcelona, the GMC’s counsel, Heather Norton, told the fitness to practise panel. The student was 31 weeks pregnant. With extremely limited exceptions the upper …
Incorrect Macroscopic Diagnosis of Colonic Carcinoma Made at Endoscopy
Authors: M. Hocke, H. Bosseckert
Journal: Endoscopy (2004)

In July 1999 we examined a 60-year-old woman who appeared to be in poor general health, with pale skin and lips. The only abnormality in the physical examination was found on palpation of the liver, which had a hardened consistency and was enlarged by about 6 cm. Typical signs of liver cirrhosis were found on ultrasound examination and previously diagnosed esophageal varices were seen at gastroscopy. Colonoscopy revealed a large, vulnerable circular growing tumor near the right flexure; the tumor was only just passable by the colonoscope (Figure [1]). A pseudopolypoid-like region was seen near the tumor. The remainder of the colon showed no abnormality. Histological examination of biopsy material revealed inflammatory and infiltrative granulation tissue.
Tenofovir Disoproxil Fumarate in Patients with HIV and Lamivudine-Resistant Hepatitis B Virus
Authors: Yves Benhamou, Roland Tubiana, Vincent Thibault
Journal: New England Journal of Medicine (2003)

Prostatectomy or Watchful Waiting in Prostate Cancerto the editor: In their article comparing prostatectomy with watchful waiting, Holmberg et al. (Sept.12 issue) 1 present their analysis according to the intention-to-treat principle, but the true treatment effect might be larger than that observed because of noncompliance with the protocol. 2Presentation of information on the outcome in the participants who did not comply with the protocol and an additional per-protocol analysis could give more insight into the real treatment effect.In addition, the authors report a statistically significant difference between the two groups in terms of distant metastases.However, outside of the protocol, untreated men might undergo a search for metastases more often than treated men.Such a difference could have serious implications for the conclusions drawn by the authors.
Rapid Serogroup Switching in<i>Neisseria meningitidis</i>
Authors: Ulrich Vogel, Heike Claus, Matthias Frosch
Journal: New England Journal of Medicine (2000)

To the Editor: In Neisseria meningitidis, the horizontal transfer of siaD genes encoding polysialyltransferases has been shown to result in capsular serogroup switching in vitro.1 The presence of c...
Novel single-balloon enteroscopy for diagnosis and treatment of the small intestine: preliminary experiences
Authors: T. Tsujikawa, Y. Saitoh, A. Andoh, H. Imaeda, K. Hata, H. Minematsu, K. Senoh, K. Hayafuji, A. Ogawa, T. Nakahara, M. Sasaki, Y. Fujiyama
Journal: Endoscopy (2007)

See also: Commentaire de travail de T. Tsujikawa et al., pp. 11Endoscopy 2008; 40(01): 89-89DOI: 10.1055/s-0032-1306800
Retrovirus infections among patients treated in Britain with various clotting factors.
Authors: R Cheinsong-Popov, R S Tedder, T O'Connor, S Clayden, A Smith, J Craske, R Weiss
Journal: BMJ (1986)

At the end of 1984 a collaborative survey was carried out to determine the prevalence of infection with human T cell lymphotropic virus type III/lymphadenopathy associated virus (HTLV-III/LAV) and HTLV-I among 584 recipients of various blood products in Britain at that time. In 204 cases yearly point prevalence figures for infection were also obtained for 1978 to 1983. In 1984, 215 of 315 patients (68%) who had received commercial concentrate for haemophilia A were identified as positive for anti-HTLV-III/LAV as compared with only 18 of 166 patients (11%) given British concentrate alone for this disease. This difference was further emphasised by the yearly point prevalence rates: seroconversion began in 1980 among recipients of commercial concentrate, but not until 1983 did such an instance occur among recipients of British concentrate. Any conclusions must remain speculative, but possibly seropositivity among haemophiliacs may not carry so grave a prognosis as previously thought.
The adjuvant‐like activity of <scp>s</scp>taphylococcal enterotoxin <scp>B</scp> in a murine asthma model is independent of <scp>IL</scp>‐1<scp>R</scp> signaling
Authors: O. Krysko, T. Maes, M. Plantinga, G. Holtappels, R. Imiru, P. Vandenabeele, G. Joos, D. V. Krysko, C. Bachert
Journal: Allergy (2013)

Abstract Background Staphylococcal enterotoxin B ( SEB ) is a superantigen known to be a modulator of chronic airway inflammation in mice and humans, yet little is known about the mechanisms that regulate its interaction with the innate immune system. We investigated this mechanism in a murine model of allergic airway inflammation induced by OVA (ovalbumin) in the presence of SEB . Methods Superantigen‐induced allergic inflammation was studied in IL ‐1R knockout ( KO ) mice exposed to OVA + SEB . Multicolor flow cytometry was used to analyze the inflammatory cell profile in airways and lymph nodes. Production of IL ‐4, IL ‐5, IL ‐10, and IL ‐13 in lymph nodes was assessed by Luminex technology. Results In wild‐type mice, endonasal instillation of OVA + SEB induced a pulmonary inflammation, characterized by an increase in the number of eosinophils, T cells, and dendritic cells and in the production of T h2 cytokines and OVA ‐specific I g E . In IL ‐1 R KO mice exposed to OVA + SEB , attraction of CD 4+ cells and production of T h2 cytokines were reduced. However, knocking out IL ‐1 R did not affect any of the features of allergic airway inflammation, such as bronchial eosinophilia, OVA ‐specific IgE production and goblet cell metaplasia. Conclusion We provide new insights into the mechanisms of airways allergy development in the presence of bacterial superantigen. The asthma features induced by OVA + SEB , such as bronchial eosinophilia, goblet cell proliferation, production of OVA ‐specific IgE and increase in inflammatory dendritic cells, are IL ‐1 R independent. Yet, IL ‐1 R signaling is crucial for CD 4 cell accumulation and T h2 cytokine production.
Progression of Lower-Extremity Arterial Occlusive Disease in Type II Diabetes Mellitus
Authors: Kirk W Beach, Geri R Bedford, Robert O Bergelin, Donald C Martin, Norma Vandenberghe, Molly Zaccardi, D Eugene Strandness
Journal: Diabetes Care (1988)

The prevalence of lower-extremity arterial occlusive disease (LEAOD), the progression of LEAOD, and the incidence of new LEAOD were determined by noninvasive method in 410 volunteers between the ages of 50 and 70 yr; 252 individuals had type II (non-insulindependent) diabetes, 158 were control subjects. LEAOD was monitored with the ankle/arm systolic blood pressure index in combination with Doppler arterial velocity waveform analysis. LEAODwas much more prevalent in the type II patients (22%, 55 of 252) than in thecontrol subjects (3%, 4 of 158) (P &amp;gt; .00001). The prevalence of risk factors for LEAOD was much higher in the type II patients, including elevated triglyceride, depressed high-density lipoprotein (HDL) cholesterol, hypertension, smoking, and elevated systolic blood pressure. In type II diabetic patients the incidence of new LEAOD over a 2-yr period (14%, 28 of 197) was lower than the incidence of LEAOD progression (87%, 45 of 52). Type II patients with LEAOD also had a high incidence of mortality (22%, 12 of 55) compared with those without LEAOD (4%, 8 of 197) (P &amp;lt; .0005). A risk score including smoking history, duration of diabetes, depressed HDL cholesterol, total cholesterol, elevated systolic blood pressure, and low obesity index is related to LEAOD. After accounting for the effect of all of the risk factors, we suggest that type II diabetes contributes additional risk for LEAOD.
Prolonged complete remission of myelodysplastic syndrome treated with danazol, retinoic acid and low-dose prednisone
Authors: I. Sadek, E. Zayed, O. Hayne, L. Fernandez
Journal: American Journal of Hematology (2000)

Myelodysplastic syndrome (MDS) is a diverse group of clonal hematologic neoplasms. Different medications have been tried in MDS; however, no effective treatment has been yet established. We report a patient with MDS who achieved a complete remission in response to combination therapy of danazol, retinoic acid, and prednisone. A 53-year-old female presented with pancytopenia, macrocytosis, and hypercellular bone marrow with erythroid hyperplasia and dysplasia and 10% ringed sideroblasts. Cytogenetic studies revealed the presence of two abnormal clones. She was diagnosed as having MDS-refractory anemia and was given blood transfusions to maintain blood cell counts at acceptable levels. At the same time, she was started on a combination of danazol (600 mg/day), retinoic acid (100 mg/day), and prednisone (10 mg every other day). Fourteen months later, the patient was in complete hematologic remission; she had normal peripheral blood count, and the blood smear showed normal morphology. Bone marrow studies revealed normal trilineage hematopoiesis. She was continued on the same combination treatment for 86 months, and she remained in complete clinical remission. Eighty-eight months from diagnosis, she relapsed with acute myeloid leukemia. This is the first reported case of MDS-RA that sustained a complete hematologic remission for a prolonged period in response to this combination treatment. This report indicates that restoration of normal hematopoiesis, prolongation of disease-free survival, and delay in the transformation to acute leukemia may be achieved by this combination of treatment in a subset of patients with MDS, especially refractory anemia with severe thrombocytopenia. Am. J. Hematol. 64:306–310, 2000. © 2000 Wiley-Liss, Inc.
Abstract C5: Role of ID4 in the development of prostate in mouse
Authors: Pankaj Sharma, Peri Nagappan, Mark A. Israel, Jaideep Chaudhary
Journal: Cancer Research (2012)

Abstract Introduction: The helix-loop-helix (HLH) family of transcriptional regulatory proteins are key players in a wide array of developmental processes. Studies in mice have convincingly demonstrated that HLH proteins are intimately involved in developmental events such as cellular differentiation and proliferation. The Id1, Id2, Id3 and Id4 gene products are closely related in their HLH regions and show similar affinities for the various E proteins but differ in their expression patterns. The function of Id proteins has recently been addressed by using a gene targeting approach in mice. Previous studies showed that Id1 null mutant mice do not exhibit abnormalities whereas reports from Id4−/− mice, found that Id4 is required for normal brain size, and regulates lateral expansion of the proliferative zone in the developing cortex and hippocampus. We have recently shown that Id4 is highly expressed in the normal human prostate, whereas its expression is epigenetically silenced in prostate cancer. However its role in normal prostate development and function is not known. Here, we demonstrate a role of Id4 in prostate development, by immunohistochemical techniques in Id4−/− mice. Experimental procedures: To investigate the precise role of Id4 in cellular proliferation and development, normal H&amp;E staining is performed on wild type and Id4−/− mouse prostate tissue. Expression of Id1, AR (Androgen receptor) and NKX3.1 on wild type and Id4−/− mouse prostate tissue was assessed by Immunohistochemistry. Results: There was no change in expression of Id1 in wild type and Id4−/− mouse prostate. Androgen receptor and NKX3.1 expression in wild type mouse was mostly nuclear but there is no expression was observed in Id4−/− mouse prostate tissue. H&amp;E staining of wild type and Id4−/− mouse prostate indicated a significant difference in the cellular morphology of Id4−/− mouse prostate tissue as compared to the wild type mouse prostate. In addition to cellular morphological changes, the size of androgen dependent reproductive tract organs such as seminal vesicle and prostate were significantly smaller in Id4−/− as compared to heterozygous and wild type mouse. Conclusions: These results suggest a severe defect in androgen response pathway and support the role of Id4 in prostate development. Difference in the size of seminal vesicles and prostate in Id4−/− mouse shows the physiological role of Id4 in androgen target organs. Size difference could be due to lack of translocation of AR to nuclei however exact molecular mechanism remains to be investigated. Acknowledgement: The research was supported by NIH/NCI-RO1CA128914 and in part by NIH/NCRR/RCMI G12RR03062. Citation Format: Pankaj Sharma, Peri Nagappan, Mark A. Israel, Jaideep Chaudhary. Role of ID4 in the development of prostate in mouse [abstract]. In: Proceedings of the AACR Special Conference on Advances in Prostate Cancer Research; 2012 Feb 6-9; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2012;72(4 Suppl):Abstract nr C5.
Dkk2 has a role in terminal osteoblast differentiation and mineralized matrix formation
Authors: Xiaofeng Li, Peng Liu, Wenzhong Liu, Peter Maye, Jianghong Zhang, Yazhou Zhang, Marja Hurley, Caiying Guo, Adele Boskey, Le Sun, Stephen E Harris, David W Rowe, Hua Zhu Ke, Dianqing Wu
Journal: Nature Genetics (2005)
Treatment of osteoporosis with human parathyroid peptide and observations on effect of sodium fluoride.
Authors: J Reeve, U M Davies, R Hesp, E McNally, D Katz
Journal: BMJ (1990)

OBJECTIVE--To evaluate the need for a randomised study of treatment of spinal osteoporosis with human parathyroid peptide in the secondary prevention of crush fractures; to study the effect of human parathyroid hormone peptide 1-34 plus sex hormones on vertebral body cancellous bone; and, separately, to determine the effect of relatively low doses of sodium fluoride plus calcium on spinal bone mineral density. DESIGN--Open study of patients with primary or postmenopausal osteoporosis. All patients had serial bone densitometry of the spine by quantitative computed tomography and dual photon absorptiometry as well as serial densitometry of the radial midshaft (cortical) and radial distal (trabecular) bone by quantitative computed tomography. Changes in the spinal bone not forming the spongiosa of the vertebral bodies ("cortical" bone) were determined from the difference between the two axial measurements, after correction to the same units of measurement. SETTING--Northwick Park Hospital and Medical Research Council Clinical Research Centre. PATIENTS--24 Patients who fulfilled the conventional criteria for type 1 (vertebral) osteoporosis not secondary to recognised causes other than sex hormone deficiency and with at least one crush or wedge vertebral fracture and a spinal bone density (quantitative computed tomography) less than 80 mg/cm3 or two or more fractures. Twelve patients received human parathyroid peptide and 12 sodium fluoride; they were not randomised. MAIN OUTCOME MEASURES--Trends in axial and peripheral bone mass values determined by linear, time dependent regression analyses. RESULTS--The patients receiving the peptide showed a substantial increase in vertebral spongiosa (mean 25.6 mg/cm2 two years after the start of treatment). No significant changes were seen in spinal cortical or radial bone density. The patients receiving sodium fluoride showed roughly equal increases in cancellous and cortical bone over the same period (mean increase in vertebral spongiosa 16.1 mg/cm3). No significant changes were seen in radial bone. CONCLUSIONS--Treatment of postmenopausal women with human parathyroid peptide selectively increases spinal cancellous bone density by amounts that may prove useful in secondary prevention. Peptide treatment should now be tested in a randomised study in which the important end point is prevention of fractures as the usefulness of sodium fluoride in this context is doubtful.