tbuckley/cabot-search huggingface dataset:
Combined Treatment of Giant-Cell Arteritis with Methotrexate and Prednisone
Authors: Juan A. Jover, César Hernández-García, Inmaculada C. Morado, Emilio Vargas, Antonio Bañares, Benjamín Fernández-Gutiérrez
Journal: Annals of Internal Medicine (2001)

Background: Corticosteroids remain the cornerstone of therapy for giant-cell arteritis, but relapse during dose tapering and corticosteroid-related adverse events often complicate management of this condition. Although several approaches, including combined therapy with cytotoxic agents, have been suggested to overcome these problems, no study has clearly shown benefits of alternate treatments. Objective: To analyze the safety and efficacy of combined therapy with corticosteroids and methotrexate in giant-cell arteritis. Design: Randomized, double-blind, placebo-controlled trial. Setting: University-based clinic. Patients: 42 patients with new-onset giant-cell arteritis according to biopsy. Intervention: High initial doses of corticosteroid were given; the dose was then tapered quickly until therapy was completely withdrawn. Methotrexate or placebo was given weekly from the start of corticosteroid therapy for 24 months. Measurements: Number of relapses, cumulative dose of corticosteroid, and number of adverse events were assessed on completion of follow-up. Results: Compared with combined prednisone and placebo therapy, treatment with prednisone and methotrexate reduced the proportion of patients who experienced at least one relapse (45% vs. 84.2%; P = 0.02) and the proportion of patients who experienced multiple relapses (P = 0.004). The mean cumulative dose of prednisone was 4187 ± 1529 mg in the methotrexate group and 5489.5 ± 1396 mg in the placebo group (mean difference, 1302 mg [95% CI, 350 to 2253 mg]; P = 0.009). Overall, the rate and severity of adverse events were similar between groups. Treatment was discontinued in 3 patients in the methotrexate group who experienced definite drug-related adverse events. In sensitivity analysis that included patients lost to follow-up, differences between groups in number of relapses and cumulative dose of prednisone were significant. Conclusions: Treatment with methotrexate plus corticosteroid is a safe alternative to corticosteroid therapy alone in patients with giant-cell arteritis and is more effective in controlling disease.
The Significance and Importance of Supervision in Psychotherapy Training
Authors: Imre Szecsödy
Journal: Psychotherapy and Psychosomatics (1990)

Though supervision has a central part in training there is little systematic study about how supervisees learn and how supervisors teach. After discussing the dynamics of interaction between trainees and supervisors and the necessity to differentiate between teaching and learning, the author summarizes the conclusions drawn from his own systematic study of the learning process in supervision.
Recoding RNA editing of AZIN1 predisposes to hepatocellular carcinoma
Authors: Leilei Chen, Yan Li, Chi Ho Lin, Tim Hon Man Chan, Raymond Kwok Kei Chow, Yangyang Song, Ming Liu, Yun Fei Yuan, Li Fu, Kar Lok Kong, Lihua Qi, Na Zhang, Amy Hin Yan Tong, Dora Lai Wan Kwong, Kwan Man, Chung Mau Lo, Si Lok, Daniel G. Tenen, Xin Yuan Guan
Journal: Nature Medicine (2013)
Variation in coverage by ethnic group of neonatal (Guthrie) screening programme in south London
Authors: A Streetly, C Grant, G Bickler, P Eldridge, S Bird, W Griffiths
Journal: BMJ (1994)

<h3>Abstract</h3> <b>Objectives</b> : To determine whether coverage of the neonatal (Guthrie) screening programme in Britain is different for groups at highest risk of sickle cell disease and to identify possible reasons for incomplete coverage. <b>Design</b> : Descriptive study of coverage of screening programme and its variation by mobility, district of residence, and ethnic group. Subjects - 1727 infants born between 1 October and 31 December 1991. Setting-Former West Lambeth and Camberwell District Health Authorities, London. <b>Main outcome measure</b> : Proportion of infants with an identifiable screening test result. <b>Results</b> : Screening covered 1663/1727 (96.3%) infants overall (745/786 (94.8%) in West Lambeth; 918/941 (97.6%) in Camberwell). The relative odds ratio of an African infant not having been tested compared with a white infant was 3.05 (95% confidence interval 1.30 to 7.14) (2.08 (0.86 to 5.01) after adjustment for mobility and district of residence). For infants whose families moved into the districts after the birth compared with those born and resident in the districts the relative odds ratio of having been tested was 10.16 (4.85 to 21.29). The odds ratio of locally delivered infants in West Lambeth not having been tested compared with those in Camberwell was 2.12 (1.08 to 4.16) after adjustment for ethnic group. <b>Conclusion</b> : Coverage of the screening programme is incomplete and poorer in infants of African ethnic group than in white infants. Poorer coverage is also associated with mobility of the family around the time of birth. The findings have implications for using the neonatal programme for testing for sickle cell disease and other disorders. Arrangements for monitoring the existing screening programme are inadequate and an improved system should be established, similar to the scheme that monitors the immunisation programme.
Personal exposure meets risk assessment: a comparison of measured and modeled exposures and risks in an urban community.
Authors: Devon C Payne-Sturges, Thomas A Burke, Patrick Breysse, Marie Diener-West, Timothy J Buckley
Journal: Environmental Health Perspectives (2003)

Human exposure research has consistently shown that, for most volatile organic compounds (VOCs), personal exposures are vastly different from outdoor air concentrations. Therefore, risk estimates based on ambient measurements may over- or underestimate risk, leading to ineffective or inefficient management strategies. In the present study we examine the extent of exposure misclassification and its impact on risk for exposure estimated by the U.S. Environmental Protection Agency (U.S. EPA) Assessment System for Population Exposure Nationwide (ASPEN) model relative to monitoring results from a community-based exposure assessment conducted in Baltimore, Maryland (USA). This study is the first direct comparison of the ASPEN model (as used by the U.S. EPA for the Cumulative Exposure Project and subsequently the National-Scale Air Toxics Assessment) and human exposure data to estimate health risks. A random sampling strategy was used to recruit 33 nonsmoking adult community residents. Passive air sampling badges were used to assess 3-day time-weighted-average personal exposure as well as outdoor and indoor residential concentrations of VOCs for each study participant. In general, personal exposures were greater than indoor VOC concentrations, which were greater than outdoor VOC concentrations. Public health risks due to actual personal exposures were estimated. In comparing measured personal exposures and indoor and outdoor VOC concentrations with ASPEN model estimates for ambient concentrations, our data suggest that ASPEN was reasonably accurate as a surrogate for personal exposures (measured exposures of community residents) for VOCs emitted primarily from mobile sources or VOCs that occur as global "background" source pollutant with no indoor source contributions. Otherwise, the ASPEN model estimates were generally lower than measured personal exposures and the estimated health risks. ASPEN's lower exposures resulted in proportional underestimation of cumulative cancer risk when pollutant exposures were combined to estimate cumulative risk. Median cumulative lifetime cancer risk based on personal exposures was 3-fold greater than estimates based on ASPEN-modeled concentrations. These findings demonstrate the significance of indoor exposure sources and the importance of indoor and/or personal monitoring for accurate assessment of risk. Environmental health policies may not be sufficient in reducing exposures and risks if they are based solely on modeled ambient VOC concentrations. Results from our study underscore the need for a coordinated multimedia approach to exposure assessment for setting public health policy.
Methods of Measuring E.S.R
Authors: H. L. Milles, H. B. Salt
Journal: BMJ (1952)

<h3>Objectives</h3> To understand the recent rise in facility deliveries in Ethiopia. <h3>Design</h3> A qualitative study. <h3>Setting</h3> Four rural communities in two regions of Ethiopia. <h3>Participants</h3> 12 narrative, 12 in-depth interviews and four focus group discussions with recently delivered women; and four focus group discussions with each of grandmothers, fathers and community health workers. <h3>Results</h3> We found that several interwoven factors led to the increase in facility deliveries, and that respondents reported that the importance of these factors varied over time. The initial catalysts were a saturation of messages around facility delivery, improved accessibility of facilities, the prohibition of traditional birth attendants, and elders having less influence on deciding the place of delivery. Once women started to deliver in facilities, the drivers of the behaviour changed as women had positive experiences. As more women began delivering in facilities, families shared positive experiences of the facilities, leading to others deciding to deliver in a facility. <h3>Conclusion</h3> Our findings highlight the need to employ strategies that act at multiple levels, and that both push and pull families to health facilities.
Talking with crowds, walking with kings
Authors: Theodore Dalrymple
Journal: BMJ (2007)

Why is so much of the commentariat—the monstrous regiment of newspaper columnists, television presenters, and literati—so hostile to our great and wholly beneficent profession?

There are two reasons, I think. The first is that we like those who have higher ethical standards than our own no more than we like those who have lower ethical standards. The second is that many critics of our profession wanted to be doctors but didn't quite make it.

Not every frustrated doctor, however, turns against the profession. Rudyard Kipling, for example, wanted to be a doctor but always held the profession in the highest regard, despite never having entered it himself. Indeed, some of his best friends were doctors, including William Gowers and John Bland-Sutton (no mean writer himself …
Experimental Nephrology: European Journal of Renal Research
Authors: J. Thomas Hjelle
Journal: JAMA (1994)

<i>Experimental Nephrology: European Journal of Renal Research</i>is a bimonthly Karger publication aimed at clinical research nephrologists. In its first issue, the editor states that the goal for this new journal is to publish both basic and clinical studies that attempt to define the developmental, cellular, and molecular biology of the kidney and the mechanisms of renal diseases. True to its title, the journal focuses on newly discovered information derived from experiments on animals and on animal and human cells, tissues, and fluids. An admirable effort is made to integrate this new knowledge into current models of human renal diseases. An appropriate diversity in timely topics and experimental approaches (eg, biochemical, physiological, and morphological) coupled with explanatory introductions and discussions is a major strength. The quality of the research is high; it is logical, founded on experimental results derived from thorough experimental design and measurement, and related to
49 SUCCESSFUL ISOLATION, CULTURING AND DIFFERENTIATION IN VITRO AND IN VIVO OF MULTIPOTENT STEM CELLS (MPS) FROM HUMAN FETAL BILIARY TREE
Authors: R. Semeraro, A. Torrice, C. Napoli, V. Cardinale, G. Carpino, R. Gentile, M. Gatto, U. Di Tondo, R. Brunelli, M.M. Anceschi, C. Napoletano, M. Nuti, E. Gaudio, D. Alvaro
Journal: Journal of Hepatology (2011)
Improved prognosis of postoperative hepatocellular carcinoma patients when treated with functional foods: a prospective cohort study
Authors: Yoichi Matsui, Junya Uhara, Sohei Satoi, Masaki Kaibori, Hitoshi Yamada, Hiroaki Kitade, Atsusi Imamura, Soichiro Takai, Yusai Kawaguchi, A-Hon Kwon, Yasuo Kamiyama
Journal: Journal of Hepatology (2002)
Immunological studies of post-streptococcal sequelae. Evidence for presence of streptococcal antigens in circulating immune complexes.
Authors: J Friedman, I van de Rijn, H Ohkuni, V A Fischetti, J B Zabriskie
Journal: Journal of Clinical Investigation (1984)

Since elevated levels of circulating complexes have been noted to occur in the sera of patients with post-streptococcal sequelae, the possibility that these complexes contained streptococcal antigens within the complex was investigated. Sera from these patients were precipitated with polyethylene glycol to extract a fraction rich in these complexes, which was then injected into rabbits. The rabbit sera were then reacted with both cellular and extracellular fractions obtained from streptococcal strains associated with either acute post-streptococcal nephritis (APSGN) or acute rheumatic fever (ARF) by using immunoelectrophoresis and ELISA techniques. The data demonstrate that both ARF and APSGN complexes contain streptococcal antigens. However, APSGN complexes react uniquely to certain extracellular antigens present in those strains associated with nephritis, while ARF complexes react specifically to certain streptococcal extracellular antigens excreted by strains associated with rheumatic fever. Neither of the two groups of complexes appear to contain streptococcal antigens related to any cellular antigens derived from the group A streptococcus. Additionally, a rabbit serum immunized with streptococcal extracellular products reacted directly with complexes isolated from nephritis patients. Removal of the gamma globulin by absorption with an anti-human Fc serum resulted in the concomitant loss of reactivity with the anti-streptococcal serum, strongly suggesting an intimate association of the streptococcal antigen with these complexes. The presence of streptococcal antigens within the circulating immune complex of patients with APSGN coupled with their specific presence in those strains associated with post-streptococcal glomerulonephritis argues strongly for a causal role of these antigens in the disease process.
Swine flu could come back in more virulent form after summer, European experts say
Authors: R. Watson
Journal: BMJ (2009)

The number of deaths in Mexico from swine influenza may be only “the tip of the iceberg” and, after a mild summer, the virus could return in a more virulent form, experts at the Stockholm based European Centre for Disease Prevention and Control said this week.

Angus Nicoll, the head of the centre’s influenza programme, said, “What we have now is a very mixed picture. We are not aware of how many people have a mild infection in Mexico and the few deaths could be the tip of the iceberg.”

Although …
Hepatitis C and alcohol
Authors: E R Schiff
Journal: Hepatology (1997)

Chronic alcoholism in patients with chronic hepatitis C appears to cause more severe and rapidly progressive liver disease leading more frequently to cirrhosis of the liver and hepatocellular carcinoma. The primary risk factor for acquiring hepatitis C among alcoholics is injection drug use. However, the epidemiology is not well defined, and other sources of spread must be important. Alcohol intake in excess of 10 g/d has been associated with increased serum hepatitis C viral RNA and aminotransferase levels, the mechanism of which is poorly understood. The histological picture of hepatitis C in patients with chronic alcoholism is typically indistinguishable from chronic hepatitis C in nonalcoholic patients. Interferon therapy is less effective among alcoholic than nonalcoholic patients, even after a period of abstinence. Patients with chronic hepatitis C should restrict their alcohol intake to less than 10 g/d, and if cirrhosis is present or interferon therapy is planned, abstinence from alcohol should be encouraged. Future research efforts should focus on the epidemiology and pathogenesis of combined chronic hepatitis C and alcoholism.
Synthesis of hemoglobin Gun Hill: increased synthesis of the heme-free βGH globin chain and subunit exchange with a free α-chain pool
Authors: Ronald F. Rieder
Journal: Journal of Clinical Investigation (1971)

Hemoglobin Gun Hill is an unstable mutant hemoglobin associated with mild compensated hemolysis. This abnormal protein has a deletion of five amino acids in the beta-chains. The deletion includes the heme-binding proximal histidine at position 92. The beta-chains of hemoglobin Gun Hill lack heme groups. Approximately 32% of the circulating hemoglobin in heterozygous subjects consists of the mutant hemoglobin. When reticulocytes were incubated with radioactive amino acid the specific activity of hemoglobin Gun Hill was three to six times that of hemoglobin A. Total incorporation of radioactivity into hemoglobin Gun Hill was two to three times that into hemoglobin A. There were 20-50% more total counts in beta-Gun Hill (beta(GH)) than in beta(A). These results indicate that in reticulocytes there was greater synthesis of the abnormal beta-chains than beta(A)-chains. The ratio of the specific activities of the alpha-chains of hemoglobin Gun Hill to the alpha-chains of hemoglobin A was 20: 1. There was evidence of a free pool of alpha-chains in the reticulocytes containing hemoglobin Gun Hill. After 10 min of incubation approximately 40% of the total alpha-chain radioactivity was in the free pool. When protein synthesis was blocked by incubation of reticulocytes with puromycin, the specific activity of the alpha-chains of hemoglobin Gun Hill continued to increase due to direct exchange of alpha-subunits between the free pool and preformed hemoglobin Gun Hill. Studies of the assembly of beta(A) and beta(GH) revealed that the rates of translation of the two polypeptide chains were equal and uniform. No evidence was obtained for the existence of "slow points" in the process of globin chain assembly. The studies also suggest that lack of strong heme-globin binding does not hinder the synthesis of globin chains.
A variant of Glanzmann's thrombasthenia with abnormal glycoprotein IIb-IIIa complexes in the platelet membrane.
Authors: A T Nurden, J P Rosa, D Fournier, C Legrand, D Didry, A Parquet, D Pidard
Journal: Journal of Clinical Investigation (1987)

Patient C.M. presented platelet function defects symptomatic of Glanzmann's thrombasthenia. However, analysis of surface-labeled platelets by SDS-polyacrylamide gel electrophoresis revealed the usual presence of the major glycoproteins, including GP IIb and GP IIIa. Platelet fibrinogen was not detected. Analysis of Triton X-100 extracts of Ca2+-washed C.M. platelets by crossed immunoelectrophoresis (CIE) showed normal amounts of GP IIb-IIIa complexes. However, when samples were electrophoresed through an agarose gel containing 125I-fibrinogen, the usual binding of fibrinogen to GP IIb-IIIa did not occur. Furthermore, the GP IIb-IIIa complexes showed an increased sensitivity to dissociation with EDTA, either after Triton X-100 solubilization or in the intact platelet membrane. For example, after incubation with EDTA at room temperature, the patient's platelets bound little of the monoclonal antibodies AP-2 or T10 (anti-GP IIb-IIIa complex) although normally binding Tab (anti-GP IIb). Patient C.M. appears to represent a subgroup of thrombasthenia where platelets contain unstable GP IIb-IIIa complexes unable to support fibrinogen binding.
Leander Starr Jameson, M.D.
Authors: Roy J. Popkin
Journal: New England Journal of Medicine (1958)

TODAY, when the medical profession is fast becoming a company of civil servants engaged primarily in filling out insurance, governmental and other forms, it is reassuring to know that in recent years there still remained a physician who not only practiced medicine successfully but left his mark as an empire builder.This man was Leander Starr Jameson. He was born in Edinburgh in 1853, the youngest of an extremely poor family of eleven, and died in 1917 in London. The family crest was a ship sailing into unknown waters with the motto "Sine Metu," meaning "Fearless." This was symbolic of . . .
Referral management centres: More Hackney carriage than Trojan horse
Authors: David Keene
Journal: BMJ (2006)

EDITOR—Davies and Elwyn note the growth of referral management centres to manage demand from primary to secondary care.1 In my area the variation in referral rates between practices varies as much as 10-fold between practices caring for the same socioeconomic and demographic group of patients. This variation is well recognised2–5 but poorly understood. Contributing …
TCT-818 Balloon Aortic Valvuloplasty In Severe Aortic Stenosis And Prevention Of Restenosis In Elderly
Authors: Polonca Kogoj, Špela Mušič, Nikola Lakič, Jana Ambrožič, Darko Zorman, Tjaša Furlan, Mirta Koželj, Matjaz Bunc
Journal: Journal of the American College of Cardiology (2012)
THE TREATMENT OF TRANSVERSE FRACTURE OF THE PATELLA BY SUBCUTANEOUS PURSE-STRING SUTURES.
Authors: JOHN B. ROBERTS
Journal: JAMA (1903)

In April, 1896, I reported<sup>1</sup>a case of patellar fracture satisfactorily treated with a catgut ligature carried around the fragments, in the coronal plane, making a sort of purse-string suture. This method seemed to me preferable to Barker's method, in which the ligature is introduced in the sagittal plane and traverses the knee joint and prepatellar bursa. I do not know that the method was new, but it is certainly deserving of extended use. Further experience has increased my confidence in it and leads me to advocate its adoption. It requires no special apparatus, such as Malgaigne's hooks, does not invade the knee joint or the synovial sac in front of the patella, and demands no general anesthetic. It is practically free from septic risks, allows the patient to get out of bed soon, and results in such a close union of the fragments that, even if true bony