tbuckley/cabot-search huggingface dataset:
Perceived aetiological factors of folliculitis keloidalis nuchae (acne keloidalis) and treatment options among Nigerian men
Authors: A. Ogunbiyi, B. Adedokun
Journal: British Journal of Dermatology (2015)

Folliculitis keloidalis nuchae (FKN) also known as acne keloidalis is the commonest form of scarring alopecia occurring in African males. It occurs mostly in individuals of African descent. Its prevalence ranges from 1·6% to 16·1%. FKN is multifactorial in origin: androgens, inflammation, trauma, ingrowing hairs and secondary infection have all been implicated in its aetiology. The reason for its occurrence in the occipital region is unclear although elevated androgens in the scalp have been suggested. The occurrence of huge keloidal-like scars in the affected area has earned the name 'Bumps' in this environment.To look at the community's perception of the aetiological factors for bumps and perceived management options available in our environment.A community study was carried out among 1003 men residing in an urban community in Mokola, Ibadan, Oyo State, Nigeria. Data on sociodemographic characteristics, knowledge about aetiology, and prevalence of shaving bumps was obtained using a semi-structured questionnaire administered by trained interviewers. The chi-squared test was used to test the associations between presence of FKN and variables.The mean age of the respondents was 31·6 (SD = 8) years. When asked about the cause of shaving bumps, 420 (41·9%) felt it was due to infection from barber's instruments, followed by heredity (110, 11%), poor shaving technique (81, 8·1%), cuts from shaving (52, 5·2%) and inadequate after shaving care (39, 3·9%). The prevalence of shaving bumps was 2·7%. The most commonly reported symptom among those with shaving bumps was itching (71·1%). Other symptoms include pain (9·6%) and bleeding (1·2%). Most of the patients (70·8%) who had ever had shaving bumps practised self-medication. Medications applied included oral and topical antibiotics (20·3%), Neo-medrol (10·9%), engine oil (9·4%) and traditional leaves (9·4%).About 50% of the responders believed FKN was an infective disorder. Although bleeding occurred while having a haircut, some individuals did not have their own personal shaving kits. Antibiotics, topical steroids, herbs and caustic substances were used for treatment. There is an urgent need to stimulate safer hair shaving practices and discourage the wrong treatment of FKN.
Impaired up-Regulation of Polo-Like Kinase 2 (PLK2) during Fludarabine- and 2-Chlorodeoxyadenosine (CdA)-Induced Cell Killing in B-Cell Chronic Lymphocytic Leukemia (B-CLL) Lymphocytes: A Potential Marker of Defective Damage Response
Authors: Emeline de Viron, Laurent Knoops, Thierry Connerotte, Caroline Smal, Lucienne Michaux, Pascale Saussoy, Françoise Bontemps, Eric Van Den Neste
Journal: Blood (2008)
Abstract 3655: Esimating Lifetime Risk for Cardiovascular Disease in Men and Women: How well does the Framingham Risk Score Add Up?
Authors: Jarett D Berry, Donald M Lloyd-Jones
Journal: Circulation (2007)

Background : The AHA and ACC recommend summing sequential 10-year risk estimates as a surrogate for direct lifetime risk estimation. Because the accuracy of this method is unknown, we sought to compare this indirect method with a direct estimate of lifetime risk. Methods and Results : We defined five mutually exclusive risk strata (all optimal risk factors, ≥1 not-optimal risk factor, ≥1 elevated risk factor, 1 major risk factor, or ≥ 2 major risk factors) based on a previously published algorithm for men and women at age 50 years. We entered combinations of risk factors corresponding to the definition of each stratum into the online Adult Treatment Panel III risk assessment tool. We created an indirect lifetime risk estimate for each risk stratum by summing the 10-year risk at ages 50-, 60-, and 70 years, comparing it to our previously published direct estimate of lifetime risk at age 50 years. Summed versus directly estimated lifetime risks for men in the 5 strata were: 30% vs 5%; 36% vs 36%; 46% vs 47%; 47% vs 50%; and 83% vs 69%. In women, the summing method substantially under-estimated remaining lifetime risks in most strata: 5% vs 8%; 7% vs 27%; 11% vs 39%; 12% vs 39%; and 32% vs 50%. Representative data from women are shown in figure . Conclusions : The indirect approach of summing 10-year risk estimates overestimated lifetime risk in men with low risk factor burden, but was generally accurate in men at higher risk. In contrast, the indirect approach substantially underestimated lifetime risk in women with any risk factors above optimal levels. Figure: Comparison of Summed vs. Lifetime Risk Estimates in Women
Drug points: Clopidogrel associated with acute arthritis
Authors: Anu Garg, Johannes Radvan, Neil Hopkinson
Journal: BMJ (2000)

Clopidogrel is a new ADP receptor antagonist used in the prevention of myocardial infarction, stroke, and vascular death. We report two cases of acute arthritis and tendonitis after clopidogrel use.

Case 1
A 76 year old woman was referred with a six year history of angina pectoris. She was stabilised on treatment but began to develop further symptoms at rest two months before referral. She had a long history of hypertension. She took atenolol 100 mg once daily, diltiazem 90 mg twice daily, isosorbide mononitrate 20 mg twice daily, and aspirin 75 mg daily.

Significant two vessel coronary artery disease was found at cardiac catheterisation. She underwent percutaneous transluminal coronary angioplasty and stent insertion of the right coronary artery. She was prescribed diltiazem 120 mg twice daily, clopidogrel 75 mg once daily, and aspirin 150 mg once daily.

Two weeks later she developed widespread pruritus, with no obvious rash, and intense pain and swelling of the metacarpophalangeal joints. The joints were red and hot, and there was synovitis. Other joints were unaffected. Her erythrocyte sedimentation rate and C reactive protein concentration were increased to 86 mm in the first hour and 81 mg/l respectively. Uric acid concentration was normal and x ray films showed soft tissue swelling only with no chondrocalcinosis. Clopidogrel was stopped.

One week later the pruritus had settled and the joint pain had improved. Repeat testing of inflammatory markers confirmed the improvement.


Case 2
A 63 year old man was referred with three episodes of chest discomfort on exertion. He was an ex-smoker and had a six year history of mild type 2 diabetes mellitus. In 1984 he had an uncomplicated subarachnoid haemorrhage. He took lisinopril 20 mg once daily and long acting diltiazem 200 mg once daily.

Severe coronary artery disease in a left dominant system was found at cardiac catheterisation. He underwent coronary artery bypass grafting. He was allergic to aspirin so was prescribed clopidogrel 75 mg once daily in addition to lisinopril.

Three weeks later he presented to his doctor with severe pain of his right knee. The knee was tender, and he was unable to bear weight on the leg. There was tenderness, heat, and swelling over the quadriceps tendon proximal to the patella. His erythrocyte sedimentation rate was mildly increased to 47 mm in the first hour. His serum urate concentration was normal. Clopidogrel was discontinued, and the symptoms resolved.

To our knowledge arthritis has not been described as a side effect of clopidogrel, and the manufacturer knows of only one case. The two cases we describe had acute musculoskeletal inflammation and increased concentrations of inflammatory markers. We recommend that clopidogrel be considered as a potential cause of arthritis.
Press: Sponsored journalism award shocks Australian media
Authors: M. Sweet
Journal: BMJ (2001)

F ancy a trip to Paris? You will fly business class, stay at a luxury hotel, dine well, and attend a conference in your area of interest.

The pharmaceutical industry is well known for using such incentives to build relationships with key opinion leaders in the medical profession. Less well known, perhaps, is that journalists are also the recipients of such largess.

When a rash of stories about impotency cropped up in the Australian media a few years ago—with headlines such as “impotence rate set to skyrocket”—it later transpired that Pfizer had sponsored the journalists involved to attend a conference on impotence in Paris.

At the time, Pfizer said it took journalists to the Paris conference …
Transcriptional analysis of purified circulating tumor cells using a novel microfluidic chip technology
Authors: Allyn Forsyth, Helen Barnes, Kimberly Helzer, Laura Day, Anne Kopf-Sill
Journal: Cancer Research (2008)

AACR Annual Meeting-- Apr 12-16, 2008; San Diego, CA

LB-300 

Background: The enumeration of circulating tumor cells (CTCs) has been demonstrated to provide a more sensitive method of detecting cancer metastases than standard radioimaging and may be useful in monitoring cancer patients for response to treatment, disease progression and early evidence of relapse. We hope to demonstrate the utility of CTCs as a real-time, surrogate “blood-based biopsy” by analyzing their nucleic acids for relevant biomarkers in disease progression and treatment selection and monitoring. Here we demonstrate the ability to collect and measure transcripts from as few as 10 cells.    Methods: We have developed a new capture method that utilizes microelectromechanical systems (MEMS) and microfabrication technology combined with immunoaffinity chemistries to selectively enrich for and capture CTCs from peripheral blood from cancer patients. The microfluidic device is the size of a microscope slide with thousands of micropillar posts and is plastic. Our platform is well-suited to post-capture analysis of CTCs, including IHC and molecular analysis. We chose to validate our capabilities for CTC gene expression analysis on a murine model of pancreatic cancer, orthotopically implanted GFP labeled PC3 cells. Murine blood (0.5 ml) is flowed through the device. GFP-PC3 cells are captured, easily visualized and can be selectively collected using laser capture microscopy. CTCs are lysed and RT-PCR amplification of relevant controls and cancer markers allowed us to examine the transcript of CTCs.    Results: Measurements of more than 30 transcripts could be made using less than 10 cells. Housekeeping genes, GAPDH and actin, responded to titration down to single cells confirming the fidelity of the CTC-chip, laser capture and RT-PCR methodology. Transcripts known to be up-regulated in prostate tumors (e.g. vimentin, krt18) were also shown to have high levels in CTCs relative to their controls.    Conclusions: Our technology effectively captures CTCs from the blood of an orthotopically implanted PC3 murine prostate model for enumeration and follow-on gene expression analysis, even from a small number of CTCs. We will discuss biomarkers in cancer disease progression and treatment selection and monitoring that we have detected in captured CTCs, and our goal to apply this technology to the clinic.
Abstract 93: Ecmo as Rescue Strategy for Refractory Cardiac Arrest and Profound Shock
Authors: David F Gaieski MD, Nicholas J Johnson, Cindy H Hsu, Sarah M Perman, Lance B Becker, Anne V Grossestreuer, Marion Leary, Michael Acker
Journal: Circulation (2013)

Background: Extracorporeal Membrane Oxygenation (ECMO) has been trialed as a rescue strategy for patients with refractory cardiac arrest unresponsive to conventional cardiopulmonary resuscitation or profound shock unresponsive to vasopressors and inotropes. Objective: We sought to describe our institution’s experience with implementation of ECMO for Emergency Department (ED) and inpatient cardiac arrests and cases of profound shock. Main variables were whether a patient was in cardiac arrest or profound shock, location of patient at time of initiation of ECMO, and our primary outcome was survival to hospital discharge. Methods: Consecutive patients placed on ECMO for the above indications were enrolled at two urban academic medical centers from July 2007 - February 2012. Results: During the study period, 44 patients were included. Average age was 44.6 years, 70% were male, 55% were white, and 77% of patients suffered from cardiac arrest. Among cardiac arrest patients, initial rhythms were ventricular fibrillation or ventricular tachycardia in 45%. Fourteen patients (32%) were cannulated in the ED. The average time from arrest to initiation of ECMO was 46 minutes (range 0.33-3.17 hours). Twenty-four patients (54%) had complications related to ECMO, which were most commonly bleeding and ischemic events. Eleven patients (25%) survived to discharge, of which 9 (20%) were neurologically intact (Glasgow Coma Scale Score of 15) at 6 months. Conclusion: In this US case series, ECMO shows promise as a rescue strategy for refractory arrest and profound shock. Further investigations are necessary to refine the technique, patient selection, and ancillary therapeutics.
Enhancement of interleukin-2-induced anti-tumor immunity by depletion of CD4+CD25+ regulatory T cells in a murine model of colon adenocarcinoma.
Authors: Hisashi Imai, Takao Takahashi, Shinji Osada, Yasuyuki Sugiyama, Yosuke Adachi, Masanao Saio, Tsuyoshi Takami
Journal: Cancer Research (2006)

5573  INTRODUCTION: Interleukin 2 (IL-2) induces the potent anti-tumor immunity, but IL-2 treatment is limited to highly selected patients because of its toxicity. CD4+CD25+ regulatory T (Treg) cells play critical roles in immunologic tolerance to self-antigens and in suppression of anti-tumor immune responses. It has been proposed that depletion of Treg cells by anti-CD25 monoclonal antibody (mAb) enhances anti-tumor immunity by expanding the proportion of tumor-specific CD8+ cytotoxic T cells. The aim of this study was to elucidate the effects of Treg cell depletion on IL-2-induced anti-tumor immunity in a murine model of colon adenocarcinoma. METHODS: In this study, we used an IL-2-transfected mouse colon adenocarcinoma cell line (MC38/IL-2). Subcutaneously implanted MC38/IL-2 cells induced anti-tumor immune responses in male C57BL/6 (B6) mice but not in mice implanted with control vector-transfected MC38 (MC38/mock) cells. To elucidate the effect of anti-CD25 mAb (PC61) administration on tumor immunity, 1×106 MC38/IL-2 cells or MC38/mock cells were implanted into the liver of B6 mice, and 0.1 mg PC61 or PBS was injected intraperitoneally every 3 days. Anti-metastatic effects of IL-2 with or without PC61 were examined by implanting 1×106 MC38/mock cells into the spleen. Seven days after tumor cell implantation, mice were treated with 5×104 U human recombinant IL-2 (rIL-2), which was administered from day 8 to day 16, and 0.1 mg PC61 every 3 days. PBS was administered instead of PC61 or rIL-2 as a vehicle control. Tumor growth and numbers of tumor-infiltrating cells were determined by flow cytometric and immunohistochemical analyses. RESULTS: Intrahepatic implantation showed tumor rejection in 5/10 mice implanted with MC38/IL-2 cells but none in the mice implanted with MC38/mock cells. PC61 treatment inhibited the proliferation of both MC38/mock and MC38/IL-2 cells in subcutaneous implantation and tumor rejection was shown in 2/5 mice and in all of 5 mice, respectively. Similarly, PC61 treatment showed no tumor formation of MC38/IL-2 cells at day 28 in intrahepatic implantation model. In MC38/IL-2 tumors with PC61 treatment, tumor-infiltrating CD8+ T cells were approximately twice as numerous as those in MC38/IL-2 tumors treated with PBS. In the intrasplenic model, the average weight of the livers of mice treated with rIL-2 plus PC61 was 1.04 ± 0.03 g, which was less than that of mice treated with rIL-2 alone (2.04 ± 0.51 g) or PC61 alone (1.81 ± 0.38 g). However, the weight of splenic tumors was similar in each group. CONCLUSION: Results of this study show the efficacy of anti-CD25 mAb treatment against murine colon adenocarcinoma. In addition, IL-2-induced anti-tumor immunity is enhanced by anti-CD25 mAb.
Abstract 19359: A Novel Parameter to Predict Long-term Cardiac Mortality in Mitral Stenosis
Authors: Maria Carmo P Nunes, Timothy Tan, Sammy Elmariah, Lucas Lodi-Junqueira, Bruno R Nascimento, Guilherme S Athayde, Xin Zeng, Rodrigo d Lago, Leilane Leon, Igor F Palacios, Judy Hung, Robert A Levine
Journal: Circulation (2014)

The prognosis of patients with mitral stenosis (MS) depends on the severity of obstruction and hemodynamic burden affecting the pulmonary vasculature. Net atrioventricular compliance (C n ) reflects the overall adverse hemodynamic consequence of MS and may be useful in predicting mortality. Methods: A total of 402 MS patients (mean age 51 ± 16 years, valve area of 1.04 ± 0.24 cm 2 , 84% female) undergoing percutaneous mitral valvuloplasty (PMV) between 2000 and 2013 at 2 centers were enrolled. Invasive hemodynamic and echocardiographic measures (pre and 24 hours post PMV) were examined and patients were followed for a median of 28 months post PMV. Endpoints were cardiovascular death (primary), and a composite of death from any cause, mitral valve replacement (MVR) or repeat PMV (secondary). Results: At baseline, 138 (34%) were in atrial fibrillation and 48% were NYHA functional class III or IV. PMV resulted in significant increase in valve area, decrease in transmitral pressure gradients, pulmonary pressures and an improvement in right ventricular (RV) function. A total of 47 (12%) died (39 cardiovascular deaths). In addition, 48 patients underwent MVR, and 12 required repeat PMV with an overall incidence of adverse events of 11.4 events per 100 patient-years. Baseline C n was a strong predictor of both cardiac death (adjusted hazard ratio [HR] 0.69, 95% confidence interval [CI] 0.49 - 0.86, p = 0.008), and composite endpoint (adjusted HR 0.81, 95% CI 0.67 - 0.91, p = 0.016). Cardiac mortality was significantly higher in patients with C n ≤ 4 ml/mmHg than in patients with C n &gt; 4 ml/mmHg (adjusted HR 0.35, 95% CI 0.16 - 0.75, p=0.007), after adjusting for clinical factors, pulmonary artery pressure, tricuspid regurgitation (TR) severity, RV function and immediate procedural results. Survival rate at 1-, 3- and 5-years follow-up was 96%, 94% and 87% in patients with C n &gt; 4 ml/mmHg compared to 89%, 79% and 75% in patients with C n ≤ 4 ml/mmHg. Conclusions: Baseline C n is a strong predictor of cardiovascular-related mortality in patients with significant MS, after adjustment for other prognostic factors including postprocedural pulmonary artery pressure. C n assessment therefore has potential value in evaluation of mortality risk in the setting of MS.
Abstract 12049: The Association of Subclinical Vascular Disease and Erectile Dysfunction at 9-Year Assessment: The Multi-Ethnic Study of Atherosclerosis (MESA)
Authors: David I Feldman, Kevin L Billups, Andrew P DeFilippis, Kanchan Chitaley, Philip Greenland, James H Stein, Matthew J Budoff, Zeina J Dardari, Roger S Blumenthal, Khurram Nasir, Michael J Blaha
Journal: Circulation (2014)

Background: In cross sectional studies, erectile dysfunction (ED) and overt clinical cardiovascular disease commonly coexist. However, the temporal relationship between subclinical vascular disease and subsequent identification of ED remains unclear. Methods: After excluding participants taking ED medications at baseline, we studied 1,862 asymptomatic men from the Multi-Ethnic Study of Atherosclerosis (MESA) with complete baseline multi-modality subclinical disease phenotyping who underwent ED assessment at MESA visit 5 (9.4 years after baseline). ED was defined by self-report per the single question self-assessment in the Massachusetts Male Aging Study. Using multivariable logistic regression (see figure legend for adjustments), we assessed the relationship between three different categories of baseline subclinical vascular disease with subsequent self-identification of ED. Subclinical vascular disease measures tested were: atherosclerosis: coronary artery calcium [CAC], carotid intima-media thickness [CIMT]; vascular stiffness: aortic distensibility, distensibility coefficient; vascular dysfunction: ankle-brachial index [ABI], flow-mediated dilation [FMD]. Results: A total of 839 men (45%) self-reported ED 9.4 ± 0.5 years after baseline. The mean age for the study population was 63.9 ± 8.9. There was a graded association between number and severity of subclinical disease abnormalities and ED. Measures of atherosclerosis were most closely associated with ED (see figure). Of the specific subclinical disease measurements, only presence of CAC and CAC&gt;100 retained significance in a fully adjusted model (OR 1.5, 1.2 - 1.9; OR 1.4, 1.1 - 1.9). Conclusions: Multiple vascular disease abnormalities tend to cluster in men who later self-report ED. Of the tested subclinical vascular disease domains, markers of subclinical atherosclerosis, in particular CAC, are most closely associated with subsequent ED nearly 10 years after baseline.
Possible role of APC gene in hematopoisis: An implication from anemia in ApcMIN/+ mice
Authors: Zhi Jian Liu, Shaojin You, William J. M. Hrushesky, Patricia A. Wood, Michael D. Wyatt, Sondra H. Berger
Journal: Cancer Research (2005)

1980  APCMIN/+ mice, with a truncated allele of APC (adenomatous polyposis coli), have been utilized widely to study intestinal tumorigenesis and APC function. However, APCMIN/+ mice do not develop metastatic cancer, and often die of progressive anemia. Anemia is thought to be a consequence of hemorrhage caused by intestinal tumors. APC plays a key role in the Wnt signaling pathway and recent evidences implicates Wnt signaling in the proliferation/differentiation switch in hematopoietic stem cells. In this study, we examined the hypothesis that the APCMIN/+ genotype compromises hematopoiesis, which either induces anemia or abrogates the ability to compensate for blood loss caused by tumor hemorrhage. A mild normocytic-normochromic anemia was observed in APCMIN/+ mice compared to wild-type littermates at 6 and 9 weeks of age. In APCMIN/+ mice in this age range, few large tumors were detected and fecal porphyrin content was comparable with wild-type littermates in mice ≤ 8 weeks. Extramedullary splenic erythropoiesis was detected in all APCMIN/+ mice at 9 weeks of age without an accompanying elevation in erythrocyte progenitors or in erythropoiesis in the bone marrow. APCMIN/+ mice ≥ 12 weeks of age developed severe hypochromic anemia in an age-dependent progressive pattern, with elevated fecal porphyrin content and significant spleen enlargement. In APCMIN/+ mice of all ages, an inverse correlation was observed between the number of large tumors and red blood cell (RBC) count and between RBC count and spleen index. Our data suggested that the development of anemia is a complex interplay of at least 3 processes: an early plateau in erythropoiesis, a shift to extramedullary erythropoiesis in the spleen with no known physiological basis, and an increase in tumor size and intestinal blood loss.