tbuckley/cabot-search huggingface dataset:
Vasculitis and granulomatosis of the respiratory tract.
Authors: C W Edwards
Journal: Thorax (1982)

Vasculitis and granulomatosis of the respiratory tractIn 1973 Liebowl grouped together a number of diseases under the heading of pulmonary angiitis and granulomatosis.These conditions, of which Wegener's granulomatosis is the most familiar, are characterised by chronic inflammation, granuloma formation, vasculitis, and necrosis.The lungs are primarily affected, but other organs may be involved.Because their clinical and radiological manifesta- tions are similar, they are frequently confused, not only with each other but also with unrelated diseases.Furthermore, they are rare and experience in their diagnosis and management is limited: there has been little opportunity for the type of multidisciplinary approach which has, for instance, solved so many of the problems of glomerular disease.Since Liebow's paper was published there have been significant advances in the treatment of these disorders, and new facts about their aetiology and their relationship to other diseases have emerged.The purpose of this editorial is to discuss the concept of pulmonary vasculitic and granulomatous disease in the light of more recent knowledge, to outline current trends in management, and to indicate the areas in which further investigation is needed. ClassificationThe diseases at present classified as pulmonary vasculitis and granulomatosis are as follows :1-4 classical Wegener's granulomatosis; limited Wegen- er's granulomatosis; lymphomatoid granulomatosis; Churg-Strauss syndrome; necrotising sarcoid granulomatosis; bronchocentric granulomatosis.The aetiology of most of these conditions is unknown or uncertain, and they must therefore be grouped according to their clinical and morphologi- cal features.The classification given here is con- venient, and forms a useful basis for diagnosis.But it has no pathogenetic implications.The lung can 6nly react to damage in a limited number of ways, and in fact each of these entities may have several different causes.
Six-month mortality rates are lower in patients with an acute coronary syndrome treated with the combination of clopidogrel and a statin than in patients treated with either therapy alone: An analysis from the global registry of acute coronary events
Authors: Michael J Lim, Frederick A Spencer, Joel M Gore, Omar H Dabbous, Eva M Kline-Rogers, Robert J Goldberg, Donna DiBenedetto, Kim A Eagle, Rajendra H Mehta
Journal: Journal of the American College of Cardiology (2003)
PTH-002 Ercp: Balancing Demand, Training And Manpower In South East Region
Authors: A Jeevagan, P Rai, G Bird
Journal: Gut (2014)

<h3>Introduction</h3> The purpose of this survey is to assess trainees attitudes and exposure to ERCP training in the south east region of England and also to explore the demand for ERCP endoscopists in future. <h3>Methods</h3> Two separate short survey questionnaires were sent using an online survey tool between July 2012 to October 2012. One was sent to the trainees and the second questionnaire was sent to the Consultant Gastroenterologists in this region. In some instances survey was conducted through telephone, e-mail or in person. <h3>Results</h3> Out of 43 trainees, nearly 10/43(23%) were getting trained in ERCP, 14/43 (33%) mentioned that their training needs had been assessed, 32/43 (75%) were not aware of the current need for consultant ERCPs in this region. Among the trainees who do not want to get trained in ERCP, 5/33 (16%) of them had interest in other sub-specialty, 4/33(14%) considered it a difficult procedure to get trained and 3/33(9%) did not have any appropriate guidance. The other reasons include high risks and complication 3/33 (9%), longer duration of training 1/33(3%) and lack of training facilities 2/33 (6%). Among the trainees who performed ERCPs only 2/10(20%) had done more than 100 procedures. None of them got more than 75% selective duct cannulation rate. Majority of trainees, about 30/43 (70%) of them pointed out that ERCP should not be an essential skill for gaining a consultant job. Out of 55 consultants gastroenterologists 27/55 (50%) of them perform ERCP. Of these 27 consultants, 18/27 (67%) trained at least one trainee. Only 3/27 (11%) consultants mentioned that they would stop doing ERCP procedures in the next 5 years and 6/27(22%) within next 10 years. 7/27 (25%) of the consultants thought that their colleague/colleagues would take over the ERCP service when they retire and 12/27 (45%) thought that new ERCP consultants will be recruited. <h3>Conclusion</h3> This survey suggests that there is currently only a need for 2–3 trainees to be learning ERCP if the current demand is stable. The number of trainees training in ERCP need to be very small unless we accept that the trained ERCP endoscopists might give up on transition to consultant. There is a disparity in that consultants claim they are delivering ERCP training but this is not reflected in the results of the trainee’s responses. Most of the trainees are in their early stage of in the ERCP training. None of the trainees got over 75% selective cannulation rate. <h3>Disclosure of Interest</h3> None Declared.
The forgotten nodule: complications of sacral nodules in rheumatoid arthritis
Authors: R. D Sturrock, E. A Cowden, E. Howie, D. M Grennan, W Watson-Buchanan
Journal: BMJ (1975)

Nodules commonly occur in rheumatoid arthritis and occasionally give rise to complications. The sacral nodule is easily missed and may ulcerate to produce extensive sacral sores which may lead to serious and even fatal complications in patients with rheumatoid arthritis. Seven cases are reported which illustrate some of these features.
Inactivation of the CYLD Deubiquitinase by HPV E6 Mediates Hypoxia-Induced NF-κB Activation
Authors: Jiabin An, Deqiong Mo, Huiren Liu, Mysore S. Veena, Eri S. Srivatsan, Ramin Massoumi, Matthew B. Rettig
Journal: Cancer Cell (2008)
Serum Enzyme Assays in the Diagnosis of Acute Myocardial Infarction Recommendations Based on a Quantitative Analysis
Authors: THOMAS H. LEE
Journal: Annals of Internal Medicine (1986)

In the last 20 years, serum enzyme and isoenzyme levels have become the final arbiters by which acute myocardial infarction is diagnosed or excluded. We review the characteristics of these enzymes, the methods and limitations of commonly used assays, and data on diagnostic accuracy and clinical implications of enzyme levels in various settings and offer recommendations on their optimal use. Because of the poor sensitivity of single measurements of cardiac enzyme levels, these assays should not be used in the emergency room to exclude myocardial infarction. If myocardial infarction is suspected, levels of creatine kinase and its MB fraction should be measured at admission and about 12 and 24 hours later. If a myocardial infarction may have occurred more than 24 hours before evaluation, then lactate dehydrogenase isoenzyme measurements may increase diagnostic accuracy. Used properly, these assays are remarkably sensitive, but like all tests, optimal interpretation requires insight into technical pitfalls and other causes of misleading results.
Abstract 4866: CLEFMA induces apoptosis and downregulates inflammatory markers in lung cancer model.
Authors: Vivek R. Yadav, Kaustuv Sahoo, Vibhudutta Awasthi
Journal: Cancer Research (2013)

Abstract Background: Inflammation is a precursor for many cancers. NF-kB plays an important role in inflammation, is associated with cancerous growth and has been identified as a potential target for development of anticancer therapies. Lung cancer is a classic example of inflammation-induced carcinogenesis where it prevents apoptosis and stimulates production of pro-inflammatory cytokines. CLEFMA or 4-[3,5-bis(2-chlorobenzylidene-4-oxo-piperidine-1-yl)-4-oxo-2-butenoic acid] is a new molecule that potently inhibits proliferation of various cancer cells without affecting normal cells. In this study, we evaluated the antiproliferative activity of CLEFMA in a mouse xenograft model of human lung cancer. Methods: Cell viability was determined in human lung cancer cells H441 and A549 after treatment with CLEFMA. Immunobloting studies were performed in cell lysates and tissue homogenates for anti-apoptotic and pro-apoptotic markers. These were further confirmed by immunohistochemical studies. The ability of CLEFMA in reducing the metabolic turnover in tumor tissue was examined by positron emission tomography using F-18-FDG as a biomarker of glucose metabolism. Results: We found that CLEFMA-induced suppression of lung adenocarcinoma H441 and A549 cell proliferation was associated with cleavage of caspases 3/9 and PARP, suggesting apoptotic cell death. In vivo, CLEFMA demonstrated a dose-dependent suppression of tumor growth associated with reduction of tumor proliferation marker Ki-67. Non-invasive PET imaging with F-18-flurodeoxyglucose also showed abrogation of glucose uptake in tumor tissue. In the tumor tissue homogenates, we found inhibition of anti-apoptotic markers cIAP1, Bcl-XL, BCL2 and survivin, and upregulation of pro-apoptotic BID cleavage, BAX and PARP. Further, CLEFMA inhibited NF-kB at mRNA level and reduced phospho-p65 translocation into the nucleus. It also reduced the expression of COX-2 in tumor tissue, and significantly reduced serum pro-inflammatory cytokines TNF-α and IL-6. Conclusions: The findings suggest that CLEFMA inhibits growth of lung cancer xenografts by activating caspase-dependent apoptotic pathway, and the tumor suppression is associated with anti-inflammatory and anti-metastatic effects, perhaps mediated by NF-kB. Citation Format: Vivek R. Yadav, Kaustuv Sahoo, Vibhudutta Awasthi. CLEFMA induces apoptosis and downregulates inflammatory markers in lung cancer model. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 4866. doi:10.1158/1538-7445.AM2013-4866
Frequency and nature of cytokine gene polymorphisms in type 1 autoimmune hepatitis
Authors: Sharon Cookson, Patrizia K. Constantini, Michael Clare, James A. Underhill, Will Bernal, Albert J. Czaja, Peter T. Donaldson
Journal: Hepatology (1999)

Genetic involvement in type 1 autoimmune hepatitis (AIH) is indicated by a marked female preponderance and strong, well-established, human leukocyte antigen (HLA) associations. These associations, however, are not universal and a number of genes outside the major histocompatibility complex may also play a role in susceptibility to type 1 AIH. Prime candidates at present are those polymorphic genes encoding the proinflammatory and immunoregulatory cytokines. The aim of this study was to investigate, for the first time, 2 members of the interleukin-1 (IL-1) family (IL-1B and IL-1RN), 3 polymorphic sites in the interleukin-10 (IL-10) gene promoter (positions -1082, -819, and -592), and 2 polymorphisms in the tumor necrosis factor-alpha (TNF-alpha) promoter (positions -308 and -238) in type 1 AIH. The study was performed on 2 independently collected DNA banks, each with appropriate controls, and throughout the analysis associations described in the first set were confirmed in the second set. Standard polymerase chain reaction (PCR)-based genotyping techniques were used. Overall there were no significant differences in the distributions of the IL-1B and IL-10 alleles, genotypes, or haplotypes in either study set. In contrast we report a significant association between type 1 AIH and TNF*2 (first set: 34% of controls vs. 49% of patients, Pc =.014 and second set: 26% vs. 56%, P =.00008). However, TNF*2 is found in strong linkage disequilibrium with the HLA A1-B8-DR3 haplotype and stratification analysis indicates that the association with TNF*2 is interdependent with HLA DRB1*0301. This is an indication that there is more than one susceptibility allele for type 1 AIH on chromosome 6p21.3.
Lysergic Acid Diethylamide
Authors: Donald B. Louria
Journal: New England Journal of Medicine (1968)

NO drug used by man has stimulated greater public-debate than lysergic acid diethylamide (LSD). This brief review of the current status of the drug will summarize its pharmacology, medical uses and dangers. No attempt will be made to analyze in detail its alleged benefits when taken indiscriminately or under uncontrolled circumstances; these include augmented aesthetic sensitivity, enhanced creativity, increased capacity for love, occurrence of transcendental experiences, acquisition of new insights and aphrodisiac effects. Suffice it to say that none of these claims are substantiated. Indeed, objective data now strongly suggest that claims of augmented aesthetic sensitivity and creativity cannot be . . .
Frequency of chondrocalcinosis of the knees in asymptomatic hyperuricaemia and rheumatoid arthritis: a controlled study.
Authors: P Hollingworth, P L Williams, J T Scott
Journal: Annals of the Rheumatic Diseases (1982)

An association has been reported between urate gout and chondrocalcinosis. Chondrocalcinosis was detected in knee radiographs of 8 of 138 gouty patients compared with none of 142 age matched nongouty normouricaemic controls (p less than 0.025). To define this association further, knee radiographs were examined of 84 patients with asymptomatic hyperuricaemia who had been carefully age matched with the gouty and control groups. Chondrocalcinosis of the knees was detected in only one patient, the difference from the control group not being significant. It therefore appears that there is an association of chondrocalcinosis with gouty arthritis, but not with asymptomatic hyperuricaemia. An association between chondrocalcinosis and rheumatoid arthritis has been suggested, but the studies were not controlled for age. To re-examine this implied association, knee radiographs were inspected of 127 patients with rheumatoid arthritis who had been age matched with the control group. Chondrocalcinosis of the knees was detected in only one patient, a difference from the control group which is not statistically significant.
Clinical Laboratory Medicine: Clinical Application of Laboratory Data
Authors: Stebbins B. Chandor
Journal: JAMA (1995)

I had the opportunity to review a previous edition of this text 11 years ago and was impressed. That edition was a fairly comprehensive discussion of a "complex and expanding field," and the same opinion comes from reviewing this edition. The text has increased in subjects, pages, tables, and figures and now totals 724 pages. The overall organization has remained much the same, and with the index, answers or discussions can be found with relative ease. The information is presented in a concise manner and is reinforced by the 42 figures, 96 tables, and 128 shaded areas scattered throughout the text. Use of these reading aids, however, is inconsistent in that some chapters have none while others have up to 38, and it is not clear what prompts such aid. Some topics, such as hepatitis and thyroid disease, have abundant tables, while the discussion on TdT (terminal deoxynucleotidyl transferase) would
An Artificial PAP Gene Breaks Self-tolerance and Promotes Tumor Regression in the TRAMP Model for Prostate Carcinoma
Authors: Elmar Spies, Wilfried Reichardt, Gerardo Alvarez, Marcus Groettrup, Peter öhlschläger
Journal: Molecular Therapy (2011)

Prostate cancer (PCa) is the most commonly diagnosed type of cancer in men in western industrialized countries. As a public health burden, the need for the invention of new cost-saving PCa immunotherapies is apparent. In this study, we present a DNA vaccine encoding for the prostate-specific antigen prostatic acid phosphatase (PAP) linked to the J-domain and the SV40 enhancer sequence. The PAP DNA vaccine induced a strong PAP-specific cellular immune response after electroporation (EP)-based delivery in C57BL/6 mice. Splenocytes from mice immunized with PAP recognized the naturally processed PAP epitopes, indicating that vaccination with the PAP-J gene broke its self-tolerance against PAP. Remarkably, DNA vaccination with PAP-J inhibited tumor growth in the Transgenic Adenocarcinoma of the Mouse Prostate (TRAMP) mouse model that closely resembled human PCa. Therefore, this study highlights a novel cancer immunotherapy approach with the potential to control PCa in clinical settings. Prostate cancer (PCa) is the most commonly diagnosed type of cancer in men in western industrialized countries. As a public health burden, the need for the invention of new cost-saving PCa immunotherapies is apparent. In this study, we present a DNA vaccine encoding for the prostate-specific antigen prostatic acid phosphatase (PAP) linked to the J-domain and the SV40 enhancer sequence. The PAP DNA vaccine induced a strong PAP-specific cellular immune response after electroporation (EP)-based delivery in C57BL/6 mice. Splenocytes from mice immunized with PAP recognized the naturally processed PAP epitopes, indicating that vaccination with the PAP-J gene broke its self-tolerance against PAP. Remarkably, DNA vaccination with PAP-J inhibited tumor growth in the Transgenic Adenocarcinoma of the Mouse Prostate (TRAMP) mouse model that closely resembled human PCa. Therefore, this study highlights a novel cancer immunotherapy approach with the potential to control PCa in clinical settings.
Physician Training Outside the Hospital: Who Pays for the Future?
Authors: JOHN D. GOODSON
Journal: Annals of Internal Medicine (1987)

Editorials1 September 1987Physician Training Outside the Hospital: Who Pays for the Future?JOHN D. GOODSON, M.D.JOHN D. GOODSON, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-107-2-415 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptModern experiments in residency training outside the hospital have required a reorganization of traditional clinics (1). Although educational, practice, and social forces that initiated these innovations continue (2-4), the methods for achieving reform have not been clearly demonstrated and the willingness of society and the profession to support change has not been secured.In 1980, the General Medicine Group Practice Program of the Robert Wood Johnson Foundation Teaching Hospital provided seed money for 15 model academic primary care medical practices. The evaluations by the Rand Corporation reported by Kosecoff and associates (5, 6) and Brook and associates (7) offer a...References1. STOECKLELEAFGROSSMANGOROLL JAJA. A case history of training outside the hospital and its future. Am J Med. 1979;66:1008-14. CrossrefMedlineGoogle Scholar2. SCHROEDERSHOWSTACKGERBERT SJB. Residency training in internal medicine: time for a change? Ann Intern Med. 1986;104:554-61. LinkGoogle Scholar3. PERKOFF G. Teaching clinical medicine in the ambulatory setting. N Engl J Med. 1984;314:27-31. CrossrefGoogle Scholar4. SHINE K. Innovations in ambulatory-care education [Editorial]. N Engl J Med. 1986;314:52-3. CrossrefMedlineGoogle Scholar5. KOSECOFFFINKBROOK JAR. General medical care and the education of internists in university hospitals. Ann Intern Med. 1985;102:250-7. LinkGoogle Scholar6. KOSECOFFBROOKFINK JRA. Providing primary general medical care in university hospitals: efficiency and cost. Ann Intern Med. 1987;107:399-405. LinkGoogle Scholar7. BROOKFINKKOSECOFF RAJ. Educating physicians and treating patients in the ambulatory setting: where are we going and how will we know when we arrive? Ann Intern Med. 1987;107:392-8. LinkGoogle Scholar8. GOODSONGOROLLBARSKY JAA. The training of physicians outside the hospital. Am J Med. 1986;146:1805-9. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byExperience with community academic practice: Strategies for the ambulatory education of residentsFinancing residency education in the ambulatory settingHow Can We Pay for Graduate Medical Education in Ambulatory Care?Correction: Incorrect Journal Name in Reference 1 September 1987Volume 107, Issue 3Page: 415-417KeywordsAcademic medicineForecastingHospital medicineResidency Issue Published: 1 September 1987 PDF downloadLoading ...
Joint Commission Offers Warnings, Advice on Adopting New Health Care IT Systems
Authors: Mike Mitka
Journal: JAMA (2009)

THE INTRODUCTION OF INFORMAtion technology (IT) to health care ultimately promises to lower operating costs and improve quality and safety. But the implementation of that technology often means unfulfilled expectations and unanticipated consequences. These in turn can lead to higher costs as more technology is added to fix existing systems, poorer quality as clinicians get frustrated and work around the technology, and the potential for harming patients through overreliance or underreliance on the systems. On December 11, the Joint Commission issued a Sentinel Event Alert warning of these issues and suggesting ways to minimize problems (http://www .jointcommission.org/SentinelEvents /SentinelEventAlert/sea_42.htm). Peter Angood, MD, the Joint Commission’s vice president and chief patient safety officer, said the organization issued the alert to help those who have been frustrated by the transition to new systems. “A lotoforganizationsare strugglingwith implementing technology,” Angood said. “They are finding the technology is not satisfying the needs they anticipated.” Themaincomponentsof IT forhealth care are computerized physician order entry, electronic medical records, and decisionsupportsystemsthathelphealth care practitioners make clinical judgments. But just purchasing such technologyandimposingitonthosewhowill use it does not guarantee success. The Joint Commission’s alert states: “The overall safety and effectiveness of technology in health care ultimately depend on its human users, ideally working in closeconcertwithproperlydesignedand installed electronic systems. Any form of technology may adversely affect the quality and safety of care if it is designed or implemented improperly or is misinterpreted.” The JointCommissionoffered13recommendations (see box) for ensuring successfultechnologyadoptionandmaintaining patient safety. These include examining workflow processes; involving clinicians in the planning, selection, design,andreassessmentof thesystem;and establishingtrainingandrefreshercourses for those using the technology. Thealert ismuchneeded,saidMichael I. Harrison, PhD, a senior research scientistat theUSAgencyforHealthcareResearchandQuality ’sCenter forDelivery, Organization, and Markets. “It is a valuable wake-up call for users, payers, and vendors. The experience to date shows we are very early on the learning curve, andthat isessentiallywhat thedocument says,” said Harrison, who has written on theunanticipatedconsequencesofusing healthcareIT(HarrisonMIetal.JAmMed Inform Assoc. 2007;14[5]:542-549). Robert M. Wachter, MD, who has also studied this issue, called the alert’s release timely. “The alert is recognition that implementing [IT for health care] is much harder than it looks,” said Wachter, professor and chief of the Division of Hospital Medicine at the University of California, San Francisco. “The early literature on this was too fawning and made conversion seem to be not hard, but the systems are immature and clunky, producing unintended consequences.”