tbuckley/cabot-search huggingface dataset:
Shoulder disorders in the elderly (a hospital study).
Authors: M D Chard, B L Hazleman
Journal: Annals of the Rheumatic Diseases (1987)

One hundred acute geriatric inpatients were assessed to investigate the prevalence of shoulder disorders; 21 had symptoms due to shoulder disease. Conditions included supraspinatus tendinitis (five), chronic rotator cuff rupture (seven), frozen shoulder (two), glenohumeral osteoarthritis (two), apatite related shoulder arthritis (one), stroke related shoulder disease (six). (Some patients had more than one shoulder condition.) The last group included painful stiff shoulders (three), glenohumeral subluxation (two), and acute shoulder-hand syndrome (one). Patients with rotator cuff rupture had bilateral disease. Only three patients had sought medical attention for their symptoms. The common occurrence of these conditions has possible implications for rehabilitation, and medical awareness is required as few may volunteer symptoms. A community based study is needed to assess the prevalence in the elderly population.
STRUCTURAL AND FUNCTIONAL CAROTID ARTERIAL MARKERS SHOW SIMILAR PREDICTIVE ACCURACY FOR THE PRESENCE AND OF EXTENT CORONARY ARTERY DISEASE
Authors: Maria I. Drakopoulou, Georgios Benetos, Konstantinos Toutouzas, Koutagiar Iosif, Constantina Aggeli, Constantina Masoura, Angelos Papanikolaou, Elias Siores, Dimitris Tousoulis, Christodoulos Stefanadis
Journal: Journal of the American College of Cardiology (2014)
Genetic variants of microsomal epoxide hydrolase and glutamate-cysteine ligase in COPD
Authors: S. Chappell, L. Daly, K. Morgan, T. Guetta-Baranes, J. Roca, R. Rabinovich, J. Lotya, A. B. Millar, S. C. Donnelly, V. Keatings, W. MacNee, J. Stolk, P. S. Hiemstra, M. Miniati, S. Monti, C. M. O'Connor, N. Kalsheker
Journal: European Respiratory Journal (2008)

The genetic factors that contribute to the development of chronic obstructive pulmonary disease (COPD) are poorly understood. Many candidate genes have been proposed, including enzymes that protect the lung against oxidative stress, such as microsomal epoxide hydrolase (EPHX1) and glutamate-cysteine ligase (GCL). To date, most reported findings have been for EPHX1, particularly in relation to functional variants associated with fast and slow metabolism of epoxide intermediates. The present study aimed to identify any association of variation in these genes with COPD susceptibility or severity. In total, 1,017 white COPD patients and 912 nondiseased age and sex matched smoking controls were genotyped for six single nucleotide polymorphisms (SNPs) in EPHX1 (including the fast and slow variants and associated haplotypes), and eight SNPs in the two genes encoding GCL. GCL is a rate-limiting enzyme in the synthesis of glutathione, a major contributor to anti-oxidant protection in the lung. No association of variation was found in EPHX1 or GCL with susceptibility to COPD or disease severity. This is the largest reported study to date and is well powered to detect associations that have been previously suggested. The current data indicate that these genetic variants are unlikely to be related to susceptibility or disease severity in white chronic obstructive pulmonary disease patients.
Effects of capsaicin on the metabolism of rheumatoid arthritis synoviocytes in vitro.
Authors: M Matucci-Cerinic, S Marabini, S Jantsch, M Cagnoni, G Partsch
Journal: Annals of the Rheumatic Diseases (1990)

The effects of capsaicin, the ingredient of hot pepper, on rheumatoid arthritis synoviocytes have been studied. Capsaicin was shown to have a direct action on the metabolism of synovial cells. Thus at 10(-6) mol/l and at higher doses DNA synthesis was restored to the control level. Capsaicin at both doses induced an increase in the synthesis of collagenase and at the lower concentration (10(-8) mol/l) only of prostaglandins. These results indicate that the different effects of capsaicin on cellular proliferation and on metabolic activities are dependent on dose. The responses seen in rheumatoid arthritis synoviocytes in vitro might not be mediated by tachykinins if the synovial tissue is still able to produce neuropeptides in the absence of neuronal afferents. These results suggest that capsaicin, in addition to its direct action on the afferent nervous fibres and the consequent release of tachykinins, may also have a direct action on the cells. The mechanisms by which capsaicin stimulates DNA synthesis and production of collagenase and prostaglandin E2, in a manner dependent on dose, remain to be determined.
The role of EGFR expression on the survival of patients with lung cancer: a systematic review of the literature with meta-analysis
Authors: Anne-Pascale Meert, Bénédicte Martin, Philippe Delmotte, Thierry Berghmans, Jean-Jacques Lafitte, Céline Mascaux, Marianne Paesmans, Emmanuelle Steels, Jean-Marc Verdebout, Jean-Paul Sculier
Journal: European Respiratory Journal (2001)
Reflections on the Discovery and Significance of Estrogen Receptor β
Authors: Konrad F. Koehler, Luisa A. Helguero, Lars-Arne Haldosén, Margaret Warner, Jan-Åke Gustafsson
Journal: Endocrine Reviews (2005)

We have known for many years that estrogen is more than the female hormone. It is essential in the male gonads, and in both sexes, estrogen has functions in the skeleton and central nervous system, on behavior, and in the cardiovascular and immune systems. An important aspect of the discovery of estrogen receptor (ER) β is that the diverse functions of estrogen can now be divided into those mediated by ERα and those mediated by ERβ. Pharmacological exploitation of this division of the labors of estrogen is facilitated by the ligand-binding specificity and selective tissue distribution of the two ERs. Because the ligand binding domains of ERα and ERβ are significantly different from each other, selective ligands can be (and have been) developed to target the estrogenic pathway that is malfunctioning, without interfering with the other estrogen-regulated pathways. Because of the absence of ERβ from the adult pituitary and endometrium, ERβ agonists can be used to target ERβ with no risk of adverse effects from chemical castration and uterine cancer. Some of the diseases in which there is hope that ERβ agonists will be of benefit are prostate cancer, autoimmune diseases, colon cancer, malignancies of the immune system, and neurodegeneration.
Antibacterial Bacteriological Swab
Authors: C. G. Crawford
Journal: BMJ (1965)

in your issue of 10 July (p.59), which would be misleading to any reader who wishes to go back to the sources of reference.It was stated that the detection of precipitating anti- bodies against Thermopolyspora polyspora was reported by Pepys and colleagues in Thorax 1962.1 Whilst this report dealt with the precipitating antibodies in farmer's lung against extracts of mouldy hay, the discovery that thermophilic actinomycetes such as T. polyspora and Thermoactinomyces (Micronionospora) vulgaris, and particularly T. polyspora, are an important source of antigens in farmer's lung was reported by Pepys et al. in the Lancet in 1963.2The antigens in specimens of mouldy hay responsible for farmer's lung and present in extracts of T. polyspora have been termed " farmer's lung hay " (FLH) antigens.A clinical evaluation of the precipitin (FLH) test in farmer's lung has been reported by Pepys and Jenkins.'This showed that an insidious onset of the attacks is not rare, as stated in your editorial.In 205 patients with farmer's lung, 49% had an insidious onset, 9 , , started with attacks of insidious onset and subsequently had the typical attacks coming on after some hours, 32% had typical attacks from the beginning, and in 10°,,, after a period of attacks with insidious or typical onset, attacks later came on more rapidly with a more marked bronchial com- ponent to the reaction.The clinical and serological findings in the patients in the different groups were comparable.Staines and Forman4 have previously reported that an insidious or typical onset occurred equally frequently.It is desirable that the different modes of presentation, other than those of the classical description, should be recog- nized.-Iam, etc.,
Patient-Physician Communication: Respect for Culture, Religion, and Autonomy-Reply
Authors: Leslie J. Blackhall
Journal: JAMA (1996)

In Reply.  —We thank Drs Pantilat and Fenyvesi for their interest in our article. Timing of discussions concerning patient preferences to be informed about their illnesses is important, and Pantilat's suggestion about this matter seems reasonable. We also agree with Fenyvesi that a trusting physician-patient relationship is the best basis for ethical decision making. Every patient is unique, but we believe it is possible to improve communication about end-of-life decisions by making clinicians sensitive to their own cultural background, their patients' background, and the conflicts that may occur when different cultures come together.
Understanding patient sensitization profiles in complex pollen areas: a molecular epidemiological study
Authors: D. Barber, F. De La Torre, F. Feo, F. Florido, P. Guardia, C. Moreno, J. Quiralte, M. Lombardero, M. Villalba, G. Salcedo, R. Rodríguez
Journal: Allergy (2008)

Background: Allergy diagnosis in patients exposed to multiple pollen species is complex and misdiagnosis is often a cause for unsuccessful specific immunotherapy. Objective: We studied the sensitization profile of individual allergens (major, minor and pan‐allergens) in pollen‐sensitized patients in a region with high exposure to olive pollen by investigating the influence of minor allergens on allergic disease and the association between pan‐ and minor allergen sensitizations. Methods: A panel of 13 purified allergens, which included the most relevant allergens in the area, as well as minor olive allergens and pan‐allergens, were screened using a high‐capacity technology (ADVIA‐Centaur ® ) in 891 patients. Results: Olive allergy as measured by specific IgE to Ole e 1 was the leading pollinosis in the area. The minor olive allergens Ole e 7 and Ole e 9 were markers of more severe allergic illness. Profilin sensitization was associated mainly with grass allergy, the second most prevalent pollinosis. Salsola kali pollen allergy was the third most common cause of pollinosis in the area. The prevalence of sensitization to the peach allergen Pru p 3, a nonspecific lipid‐transfer protein, was notable. Conclusion: Epidemiological analysis by component‐resolved diagnosis is a new method, which elucidates the interaction between allergen exposure gradient and patient sensitization. High exposure leads to differential sensitization profiles some of which are associated with more severe allergic conditions. Profilin sensitization, related mainly to grass pollinosis, was a marker of more severe grass pollen sensitization.
Ductal Carcinoma In Situ in <i>BRCA</i> Mutation Carriers
Authors: E. Shelley Hwang, Jane L. McLennan, Dan H. Moore, Beth B. Crawford, Laura J. Esserman, John L. Ziegler
Journal: Journal of Clinical Oncology (2007)

Purpose The current literature suggests that ductal carcinoma in situ (DCIS) of the breast is infrequently diagnosed in patients with BRCA germline mutations. We studied women at high risk of hereditary breast cancer syndromes who underwent testing for BRCA1 and BRCA2 to estimate DCIS prevalence and incidence in known BRCA-positive women compared with high-risk women who were mutation negative. Methods We analyzed breast event outcomes in a retrospective cohort of 129 BRCA-positive and 269 BRCA-negative women undergoing genetic testing for a BRCA mutation between September 1996 and December 2003 at University of California, San Francisco. We estimated the frequency of DCIS and invasive cancer and time to breast events from birth using a Cox proportional hazard model for competing risks. Histologic grade of DCIS was also compared between groups. Results Among BRCA carriers, 48 (37%) had DCIS (with or without invasive cancer) compared with 92 noncarriers (34%). Univariate analysis showed that both DCIS and invasive cancer had an earlier onset in mutation carriers than in noncarriers, although on a per-woman basis, this difference was not statistically significant. High-grade DCIS was more common in BRCA1 mutation carriers than in patients without a mutation (P = .02). Conclusion DCIS is equally as prevalent in patients who carry deleterious BRCA mutations as in high familial-risk women who are noncarriers, but occurs at an earlier age. Our results argue for the consideration of DCIS as a criterion for BRCA risk assessments with appropriate weighting in prediction models such as BRCAPRO.
Value of thallium-201 imaging in detecting adverse cardiac events after myocardial infarction and thrombolysis: a follow up of 100 consecutive patients
Authors: S. Basu, R. Senior, C. Dore, A. Lahiri
Journal: BMJ (1996)

<h3>Abstract</h3> <b>Objective</b>: To determine the prognostic role of thallium-201 imaging compared with that of exercise electrocardiography in patients with acute myocardial infarction treated by thrombolysis. <b>Design</b>: Patients who remained free of adverse cardiac events six weeks after myocardial infarction had stress and rest <sup>201</sup>Tl imaging and exercise electrocardiography and were followed up for 8–32 months. Adverse cardiac events (death, reinfarction, unstable angina, and congestive heart failure) were documented. <b>Setting</b>: Large district general hospital, Middlesex. <b>Subjects</b>: 100 consecutive male and female patients who were stable six weeks after thrombolysis for myocardial infarction. <b>Main outcome measures</b>: Prediction of occurrence of adverse cardiac events after myocardial infarction by exercise cardiography and <sup>201</sup>Tl myocardial perfusion imaging. <b>Results</b>: Reversible ischaemia on <sup>201</sup>Tl imaging predicted adverse cardiac events in 33 out of 37 patients with such events during follow up (hazard ratio 8.1 (95% confidence interval 2.7 to 23.8), P&lt;0.001). Exercise electrocardiography showed reversible ischaemia in 33 patients, of whom 13 had subsequent events, and failed to predict events in 24 patients (hazard ratio 1.1 (0.56 to 2.2), P = 0.8). <b>Conclusion</b>: <sup>201</sup>Tl imaging is a sensitive predictor of subsequent adverse cardiac events in patients who have received thrombolysis after acute myocardial infarction, whereas exercise electrocardiography fails to predict outcome. <h3>Key messages</h3> Exercise electrocardiography is a poor predictor of such events Presence of reversible ischaemia on <sup>201</sup>Tl imaging identifies 89% of patients who subsequently have such events
Laboratory Methods in Enteric Fevers
Authors: J. S. K. Boyd
Journal: BMJ (1939)

and Conclusions The results of internal pneumolysis in an unselected group of 235 cases, in 50 per cent. of which the disease was far advanced, are reported, including twenty with bilateral artificial pneumothorax.Division of all adhesions was possible in 34 per cent. of pneumothoraces operated on, and partial division in 55 per cent.; 11 per cent.were inoperable.Radiologically satisfactory results were obtained in 39 per cent., 14 per cent.were improved but not satisfactory, 28 per cent.were unaffected, and in 19 per cent.partial or complete symphysis followed the operation.In the group of 140 pneumothoraces in which only partial division of adhesions was possible, a satisfactory collapse followed the operation in 28 per cent.Medial subapical adhesions rarely interfere with efficient collapse where the apex of the lung is below the clavicle in the upright position.Lateral -or lateral apical adhesions may be usefully divided in patients with inoperable medial apical adhesions or apical symphysis in the presence of patent cavities below the level of the clavicle.Satisfactory results were most frequent with limited lesions in apyrexial patients.Apart from effusions, complications were rare.Follow- ing 260 operations, effusions occurred in 32.8 per cent. of operations (8.4 per cent.transient, 10.9 per cent.persistent TB negative, 13.5 per cent.persistent TB positive).Transient effusions did not materially affect the result of the operation.Results were poor where the operation was followed by persistent effusions, particularly those in which tubercle bacilli were present and the incidence of partial or complete obliteration was high.Effusions were most common in cases with advanced disease, any degree of pyrexia, rapid sedimentation rates, or in cases where extensive cauterization was carried out.Consideration of the first three of these factors is of importance in estimating the probability of effusion following the operation.The radiological diagnosis of an inoperable apical sym- physis in forty-six cases was confirmed by thoracoscopy.Apart from this group, radiological examination was un- reliable in determining the position or extent of the adhesions present.Stereoscopic examination was more reliable than fluoroscopy and antero-posterior films, but was not of enough value to warrant routine use.Facilities for intrapleural pneumolysis are essential for the proper conduct of artificial pneumothorax treatment, and the operation may be of value even in advanced cases.The place of double artificial pneumothorax and phrenic evulsion in intrapleural pneumolysis is indicated.
Skeletal hyperostosis and extraosseous calcification in patients receiving long-term etretinate (Tigason)
Authors: D.J. WILSON, V. KAY, M. CHARIG, D.G. HUGHES, T.S. CREASY
Journal: British Journal of Dermatology (1988)

In an ongoing study of patients on long-term etretinate (Tigason) therapy, 13 patients with a congenital or inherited disorder of keratinization and 10 patients with psoriasis were examined to investigate the incidence of, and the factors associated with, skeletal hyperostosis. Skeletal scintigraphy, plain radiographs, haematological and biochemical analyses were performed. Using all criteria, 7 of 13 patients with a congenital or inherited disorder of keratinization showed evidence of hyperostosis. No single investigation was able to detect all these cases; in particular, skeletal scintigraphy was positive in only nine of the 13 patients who showed hyperostosis. Eleven of the 13 patients with hyperostosis gave a history of musculoskeletal symptoms compared with three of the 10 patients without hyperostosis. There was no clear association with total dose or duration of treatment. Serum chemistry and haematological studies were normal. In two patients the 24-h urinary calcium excretion was significantly elevated, an abnormality which has not been described previously. Annual lateral thoracic spine radiographs with additional views of symptomatic areas are recommended for patients on long-term etretinate therapy.
Abstract 2300: Silencing of the transcription repressor HOXA2 by aberrant hypermethylation enhances invasion via MMP-9 activation in NPC
Authors: Chen-Ching Peng
Journal: Cancer Research (2014)

Abstract Nasopharyngeal carcinoma (NPC) is notorious for its high invasiveness and metastatic ability. In this study, we identified a differential hypermethylated transcription repressor, Homeobox A2 (HOXA2), which may render NPC cells invasive and metastatic. Aberrant hypermethylation of HOXA2 led to low RNA expression in NPC tumors and cells. Addition of methylation inhibitor 5′Aza restored HOXA2 RNA expression in NPC cells. Methylated HOXA2 promoter reduces the binding affinity of the transcriptional co-activator p300, causing transcriptionalrepression of HOXA2. In NPC cells, re-expression of ectopic HOXA2 wascorrelated with decreased invasive ability and reduced metalloproteinase MMP-9 RNA and protein expression. Promoter, ChIP and DNA-pull down assays indicated that HOXA2 competes with the transcription activator, TATA-box binding protein (TBP) for a recognition sequence near the MMP-9 transcription start site, and suppresses MMP-9 transcription. Thus, HOXA2 acts as a suppressor or TBP-antagonist to inhibit MMP-9 expression; while methylation-mediated inactivation of HOXA2 in NPC derepresses MMP-9 production and increases invasion of NPC cells. In NPC plasma samples, increased plasma EBV copy number was correlated with increased in cell-free HOXA2 hypermethylation and elevated MMP-9 levels. Plasma EBV DNA and methylated cell-free HOXA2 can be used as biomarkers for monitoring NPC treatment. Note: This abstract was not presented at the meeting. Citation Format: Chen-Ching Peng. Silencing of the transcription repressor HOXA2 by aberrant hypermethylation enhances invasion via MMP-9 activation in NPC. [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 2300. doi:10.1158/1538-7445.AM2014-2300
Lesson of the week: Post-traumatic stress disorder following military combat or peace keeping
Authors: R. Gabriel
Journal: BMJ (2002)

Psychological or somatic dysfunction after military conflict may hide post-traumatic stress disorder

Trauma related to military service is not only physical. Since the American civil war it has been recognised that a proportion of veterans have symptoms but few physical signs.1 Conflicts and peacekeeping tours potentially carry long term psychiatric consequences. There is a strong concordance between symptoms after conflict regardless of the conflict.1 Histories of physical symptoms would be similar if taken from veterans of any of the 20th century conflicts. In the Gulf Veterans' Medical Assessment Programme we continue to recognise new cases of post-traumatic stress disorder.2 We present four histories of people who served in the Gulf during the conflict. All patients were provisionally diagnosed by RG and the diagnoses confirmed by consultant psychiatrists.

Usually the diagnosis is not difficult, and its initial recognition is within the ability of all medical practitioners. According to the Diagnostic and Statistical Manual of Mental Disorders , fourth edition (DSM-IV),3 initiation of post-traumatic stress disorder comprises experiencing, witnessing, or being confronted with a catastrophic stressor event that involves actual or threatened death or serious injury or a threat to the physical integrity of self or others. The response involves intense fear, helplessness, or horror (box).

#### Criteria for diagnosis of post-traumatic stress disorder

Re-experiencing the trauma by recurrent, intrusive, distressing recollections of the stressor

Persistent efforts at avoidance of the memories and numbing of general responsiveness by adjustments in behavioural and cognitive patterns with emotional blunting

Persistent symptoms of hyperarousal: sleep impairment, irritability, reduced concentration, hypervigilance, and exaggerated startle response

### Case 1

During active service in Northern Ireland the patient was involved in a helicopter crash. The patient was strapped in but the blood and brains of his “best mate” spattered him. Four months of psychological help was deemed successful. Later, in the Gulf war, observation of …