tbuckley/cabot-search huggingface dataset:
OP0200-PC Step-Up: An Innovative Stepped-Care Protocol for Tailored Behavioral Medicine Treatment in the Management of Musculoskeletal Pain in Primary Care
Authors: P. Åsenlöf, I. Demmelmaier, C. Emilson, S. Pettersson, S. Bergman
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Multimodal rehabilitation and tailored behavioral medicine treatments should be provided to patients suffering from persistent and activity limiting pain according to current state-of-science. There is also evidence that a minimal intervention including 'stay-active advice' can produce effects comparable to effects of comprehensive treatment packages. Nevertheless, there is a gap of knowledge regarding which individuals who benefit the most from which modalities of pain treatment, at what time point, and with the highest cost-effectiveness. Accordingly, we have set up an innovative stepped-care protocol for the management of musculoskeletal pain in primary care, which is evaluated in a randomized controlled trial. <h3>Objectives</h3> The aim is to compare effects and cost-effectiveness of a stepped care model including advice and tailored behavioral medicine pain treatment (experimental condition) with a stepped care model including advice and physical exercises (comparison condition) for patients with low back and neck pain and/or widespread pain including fibromyalgia in primary care. A further aim is to characterize patients who benefit/do not benefit from the respective steps i.e. treatments varying in dose and content. <h3>Methods</h3> A stratified randomized stepped care design is applied. Stratification is based on primary care center and psychological risk profile. A consecutive selection is performed at primary care centers in southern, central and northern Sweden. After having received a minimal intervention (step 1) comprising 'stay-active advice', participants scoring high on the Örebro Musculoskeletal Pain Questionnaire (ÖMPQ) according to preset criteria are randomly allocated to an eight-week treatment in step 2. The experimental condition includes supervised physical exercises integrated with either (a) graded activity, or (b) hierarchical graded exposure depending on psychological risk profile. The comparison condition includes supervised physical exercises irrespective of risk profile. Primary outcome is pain-related disability complemented with a comprehensive set of secondary outcomes adhering to the IMMPACT recommendations. <h3>Results</h3> The stepped-care design will be presented including illustrations of conclusions possible to draw with this kind of innovative design. <h3>Conclusions</h3> There is a call for stepped-care interventions within pain intervention research, particularly in the primary care setting. However, published studies are still lacking. This study will contribute to an important progression of behavioral medicine pain treatments by the way treatments are tailored in accordance with psychological risk profile. This will be discussed to stimulate research activities and collaboration within this area of research and clinical implementation. <h3>Disclosure of Interest</h3> None Declared
Serum Long-Chain n-3 Polyunsaturated Fatty Acids and Risk of Hospital Diagnosis of Atrial Fibrillation in Men
Authors: Jyrki K. Virtanen, Jaakko Mursu, Sari Voutilainen, Tomi-Pekka Tuomainen
Journal: Circulation (2009)

Atrial fibrillation (AF) is a common cardiac arrhythmia. Regular fish consumption has been shown to reduce the risk of AF in some but not all studies. Long-chain n-3 polyunsaturated fatty acids (PUFAs) from fish have been suggested to account for these beneficial effects. We tested this hypothesis by studying the association between the serum long-chain n-3 PUFAs eicosapentaenoic acid, docosapentaenoic acid, and docosahexaenoic acid and risk of AF in men.A total of 2174 men from the prospective population-based Kuopio Ischemic Heart Disease Risk Factor Study, 42 to 60 years old and free of AF at baseline in 1984 to 1989, were studied. During the average follow-up time of 17.7 years, 240 AF events occurred. In the Cox proportional hazards model, the multivariable-adjusted hazard ratio in the highest (>5.33%) versus the lowest (<3.61%) quartile of eicosapentaenoic acid plus docosapentaenoic acid plus docosahexaenoic acid was 0.65 (95% confidence interval 0.44 to 0.96, P for trend=0.07). Evaluated individually, only serum docosahexaenoic acid was associated with the risk of AF (hazard ratio in the highest versus the lowest quartile 0.62, 95% confidence interval 0.42 to 0.92, P for trend=0.02). Exclusion of subjects (n=233) with myocardial infarction or congestive heart failure either at baseline or that preceded the AF event during follow-up slightly strengthened the associations. Serum intermediate chain-length n-3 PUFA, alpha-linolenic acid, or hair methylmercury concentration were not associated with the risk.An increased concentration of long-chain n-3 PUFAs in serum, a marker of fish or fish oil consumption, may protect against AF. Serum docosahexaenoic acid concentration had the greatest impact.
Expression of hair follicle stem cells detected by cytokeratin 15 stain: implications for pathogenesis of the scarring process in cutaneous lupus erythematosus
Authors: K. Al-Refu, S. Edward, E. Ingham, M. Goodfield
Journal: British Journal of Dermatology (2009)

Background Discoid lupus erythematosus (DLE) is a scarring disease. Although the scarring and deformity may affect any part of the body, such changes have been reported to be most obvious on the face and scalp. The pathogenesis behind this scarring process is not well understood. Once lesions have scarred, recurrent disease tends to occur at the edge of the scarred lesions but not within them. Objectives The fact that inflammation in DLE generally involves the bulge area of the follicles raises the possibility that damage to the stem cells of the bulge region may be one process leading to the permanent loss of follicles. The aim of this study was to investigate the role of the hair follicle stem cells which reside in the bulge region in the scarring process in cutaneous lupus erythematosus (CLE). Methods We studied the reactivity of an antibody to the CD8 antigen (C8/144B), which recognizes cytokeratin (CK) 15 and preferentially immunostains hair follicle stem cells without staining the remaining hair follicle, on skin biopsies (scalp and body lesions) from patients with CLE (36 with discoid lesions and 10 with subacute lesions). Normal scalp and body biopsy specimens served as controls. The correlation between the extent of the cytotoxic inflammatory cell infiltrate (CD8+) and the presence of stem cells was investigated. Results were analysed semiquantitatively. Results The expression of CK15 in hair follicle stem cells was variable in the DLE lesions; there was normal to moderate CK15 expression at the bulge region of hair follicles when surrounded by mild or moderate inflammatory infiltrate (CD8+), but in cases of severe inflammation, CK15 expression was weak or absent. Conclusions The bulge region appears to be involved in this disease as part of a broader involvement of the hair follicles; it is secondarily affected by the surrounding inflammatory cell infiltrate. Expression of C8/144B diminished and was then absent, indicating either damage to stem cells or differentiation to help in the repair process. Damage to follicular stem cells may help to explain the irreversible alopecia and the scarring process which characterize this disease.
SMALLPOX IN TWINS AT BIRTH
Authors: James A. Martin
Journal: JAMA (1925)

Mrs. W. H. N., aged 25, the mother of four children of normal pregnancy and delivery, while in the second stage of a very severe attack of smallpox, gave birth to twins, May 6, 1925, a 7 pound (3.2 kg.) boy, and a 6 pound (2.7 kg.) girl. Both babies were born in the first, or papular stage, of smallpox. The boy had twenty or thirty papules scattered over the face and body; the girl, ten or fifteen. The boy has had a very severe attack of the disease, while the girl has had a rather mild attack. The mother has entirely recovered. The babies are now in the last stage of desiccation, and look as if they will make an uneventful recovery.
Altered microRNA profiles in bronchoalveolar lavage fluid exosomes in asthmatic patients
Authors: Bettina Levänen, Nirav R. Bhakta, Patricia Torregrosa Paredes, Rebecca Barbeau, Stefanie Hiltbrunner, Joshua L. Pollack, C. Magnus Sköld, Magnus Svartengren, Johan Grunewald, Susanne Gabrielsson, Anders Eklund, Britt-Marie Larsson, Prescott G. Woodruff, David J. Erle, Åsa M. Wheelock
Journal: Journal of Allergy and Clinical Immunology (2013)
Screening for Tuberculosis-Reply
Authors: Bess Miller
Journal: JAMA (1995)

<h3>In Reply.</h3> —We welcome the comments of Dr Bayuk and Dr Fleenor and Ms Curtis. Prior to their arrival in the United States, applicants for immigrant and refugee status are screened for active TB; chest radiographic examinations are required for all persons 15 years of age or older. Individuals with abnormal chest radiographs must submit sputum samples for acid-fast bacillus examination. If classified as noninfectious (negative sputum for acid-fast bacillus), persons with possible evidence of TB are permitted entrance to the United States, but are given a notification and must report to the local health department for further evaluation soon after arrival. Because of the high prevalence of active TB among persons with such notifications,<sup>1</sup>local health departments should ensure that this group is promptly assessed. In addition, health departments should identify persons from countries with a high prevalence of TB to assess for latent TB infection and provide
Developmental toxicity of four glycol ethers applied cutaneously to rats.
Authors: B D Hardin, P T Goad, J R Burg
Journal: Environmental Health Perspectives (1984)

Previous NIOSH studies demonstrated the embryo- and fetotoxicity and teratogenicity of ethylene glycol monoethyl ether (EGEE) applied to the shaved skin of pregnant rats. In the present study ethylene glycol monoethyl ether acetate (EGEEA), ethylene glycol monobutyl ether (EGBE), and diethylene glycol monoethyl ether (diEGEE) were tested in the same experimental model, using distilled water as the negative control and EGEE as a positive control. Water or undiluted glycols were applied four times daily on days 7 to 16 of gestation to the shaved interscapular skin with an automatic pipetter. Volumes of EGEE (0.25 mL), EGEEA (0.35 mL), and diEGEE (0.35 mL) were approximately equimolar (2.6 mmole per treatment). EGBE at 0.35 mL four times daily (approximately 2.7 mmole per treatment) killed 10 of 11 treated rats, and was subsequently tested at 0.12 mL (0.9 mmole) per treatment. EGEE- and EGEEA-treated rats showed a reduction in body weight relative to water controls that was associated with completely resorbed litters and significantly fewer live fetuses per litter. Fetal body weights were also significantly reduced in those groups. Visceral malformations and skeletal variations were significantly increased in EGEE and EGEEA groups over the negative control group. No embryotoxic, fetotoxic, or teratogenic effects were detected in the EGBE- or diEGEE-treated litters.
How to protect day-care center children from infectious disease?
Authors: Donald E. Riesenberg
Journal: JAMA (1986)

Children's risk of acquiring infectious diseases from attending a day-care center continues to be scrutinized. The Interscience Conference on Antimicrobial Agents and Chemotherapy, held in Minneapolis, was the scene of the latest discussions. It is estimated that more than half of working women in the United States have children younger than 6 years of age (<i>Newsweek</i>Sept 2, 1985, p 59). Michael T. Osterholm, PhD, MPH, state epidimiologist for Minnesota, says the figure in his state is about 60%. Osterholm has predicted that, by the end of this decade, there will be 10 million children in day-care facilities (<i>JAMA</i>[MEDICAL NEWS] 1984; 251:1245-1251). In this increasingly crowded scene, diarrheal disease represents one of the most common infections. Outbreaks of diarrhea occur most frequently in those centers that care for infants and toddlers—children not yet toilet trained. Education of the center staff members in preventive measures may be more difficult than
Globus Hystericus (Globus Sensation)
Authors: Richard Schatzki
Journal: New England Journal of Medicine (1964)

THE radiologist has an unusual opportunity to converse with and collect the histories of patients whose final diagnosis is "globus hystericus." In the course of many years I have made some simple observations that may be worth recording.The majority of these patients are sent to the radiologist because they have the feeling of a lump or a foreign body in the lower part of the neck or behind the upper portion of the sternum. Many of them are said to have difficulty in swallowing. When asked whether the difficulty is more obvious during meals or between meals, they usually . . .
Pituitary Adenylate Cyclase-Activating Polypeptide (PACAP) and PACAP/Vasoactive Intestinal Polypeptide Receptors: Actions on the Anterior Pituitary Gland*
Authors: STEPHEN R. RAWLINGS, MARDJAN HEZAREH
Journal: Endocrine Reviews (1996)

I. Introduction PITUITARY adenylate cyclase activating polypeptide (PACAP) was first isolated from ovine hypothalamus by its potent activity in stimulating cAMP production in rat anterior pituitary cells (1). Since its isolation a wealth of literature has been published describing its activity in a variety of tissues including pituitary, brain, adrenal, testis, and in the nerve fibers of both the gut and the lung. A number of reviews have discussed its actions in a variety of cell types (2–4), its binding sites (5), and the characteristics of the three PACAP receptors cloned to date, two of which it apparently shares with vasoactive intestinal polypeptide (VIP) (4, 6, 7). The present review will deal specifically with the putative role of PACAP as a hypophysiotropic factor regulating anterior pituitary cell activity: This review begins with a brief history of PACAP and a description of its structure and its receptors. We will then discuss the distribution of PACAP in the hypothalamus, which suggests its role as a hypophysiotropic factor, and review the literature describing the effects of this peptide on each anterior pituitary cell type in turn.
Oncogene-specific gene expression signatures at preneoplastic stage in mice define distinct mechanisms of hepatocarcinogenesis
Authors: Cédric Coulouarn, Luis E. Gomez‐Quiroz, Ju‐Seog Lee, Pal Kaposi‐Novak, Elizabeth A. Conner, Tatyana A. Goldina, Galina E. Onishchenko, Valentina M. Factor, Snorri S. Thorgeirsson
Journal: Hepatology (2006)

We applied a genome-wide microarray analysis to three transgenic mouse models of liver cancer in which targeted overexpression of c-Myc, E2f1, and a combination of the two was driven by the albumin promoter. Although gene expression profiles in HCC derived in all three transgenic lines were highly similar, oncogene-specific gene expression signatures were identified at an early dysplastic stage of hepatocarcinogenesis. Overexpression of E2f1 was associated with a strong alteration in lipid metabolism, and Srebp1 was identified as a candidate transcription factor responsible for lipogenic enzyme induction. The molecular signature of c-Myc overexpression included the induction of more than 60 genes involved in the translational machinery that correlated with an increase in liver mass. In contrast, the combined activity of c-Myc and E2f1 specifically enhanced the expression of genes involved in mitochondrial metabolism--particularly the components of the respiratory chain--and correlated with an increased ATP synthesis. Thus, the results suggest that E2f1, c-Myc, and their combination may promote liver tumor development by distinct mechanisms. In conclusion, determination of tissue-specific oncogene expression signatures might be useful to identify conserved expression modules in human cancers.
Gene therapy rescues cilia defects and restores olfactory function in a mammalian ciliopathy model
Authors: Jeremy C McIntyre, Erica E Davis, Ariell Joiner, Corey L Williams, I-Chun Tsai, Paul M Jenkins, Dyke P McEwen, Lian Zhang, John Escobado, Sophie Thomas, Katarzyna Szymanska, Colin A Johnson, Philip L Beales, Eric D Green, James C Mullikin, NISC Comparative Sequencing Program, Aniko Sabo, Donna M Muzny, Richard A Gibbs, Tania Attié-Bitach, Bradley K Yoder, Randall R Reed, Nicholas Katsanis, Jeffrey R Martens
Journal: Nature Medicine (2012)
Selective Coronary Arteriography by Percutaneous Left Transaxillary Approach Using Preshaped Torquecontrol Catheters
Authors: J. EDSON PRICE, JOSEF RÖSCH
Journal: Circulation (1973)

The percutaneous left transaxillary use of preshaped, torquecontrol coronary catheters is considered the technique of choice for selective coronary arteriography in patients with occlusive arterial ileofemoral disease and aortopelvic reconstructive surgery. It affords reliable, selective catheterization of the coronary arteries and their bimodal (cine and serial) examination. Percutaneous left transaxillary selective coronary angiography is a safe and useful technique when performed by experienced and skilled personnel in properly selected patients.
Overview of randomised trials of diuretics in pregnancy.
Authors: R Collins, S Yusuf, R Peto
Journal: BMJ (1985)

Over the past 20 years at least 11 randomised trials of the prevention with diuretics of pre-eclampsia and its sequelae have been undertaken. Nine of these were reviewed. Reliable data from the remaining two were not available. The nine reviewed had investigated a total of nearly 7000 people. Significant evidence of prevention of "pre-eclampsia" was overwhelming, even when oedema was not included as a diagnostic criterion. But as the definitions of pre-eclampsia that had been used depended heavily on increases in blood pressure this evidence may simply have reflected the well known ability of diuretics to reduce blood pressure. When the data on perinatal death were reviewed a little difference was seen in postnatal survival. The incidence of stillbirths was reduced by about one third with treatment, but, perhaps owing to small numbers (only 37 stillbirths), the difference was not significant. Thus these randomised trials failed to provide reliable evidence of either the presence or the absence of any worthwhile effects of treatment with diuretics on perinatal mortality. The implications of this for current and future trials of beta blockers and other agents in the prevention of pre-eclampsia and its sequelae are that extremely large, ultra simple randomised trials are needed, of a size sufficient to permit direct assessment of the effects of treatment not on pre-eclampsia but on perinatal mortality itself. This may require the study of tens of thousands of pregnancies.
p16 and ARF: activation of teenage proteins in old age
Authors: Ande Satyanarayana, K. Lenhard Rudolph
Journal: Journal of Clinical Investigation (2004)

Cellular senescence induced by different stresses and telomere shortening appears to play an important role in the aging process. The products of the INK4a/ARF locus — p16INK4a and ARF — arrest cell proliferation at the senescence stage by exerting their effects on retinoblastoma protein– and p53-mediated responsive pathways. A study in this issue of the JCI provides experimental evidence of a specific upregulation of these cell cycle inhibitors in a variety of organs during mammalian aging.
Supine and Upright Radionuclide Esophageal Transit Before and After Treatment for Achalasia
Authors: JOHN B. MARSHALL, GARY BODNARCHUK, AMOLAK SINGH
Journal: Clinical Nuclear Medicine (1994)

The authors hypothesized that radionuclide esophageal transit (RET) studies performed in the upright position and aided by gravity would provide better objective evaluation of achalasia than supine scanning and would correlate better with the degree of symptomatic relief after treatment. Radionuclide esophageal transit studies were prospectively performed in both the supine and upright positions in four symptomatic patients before treatment, after simple dilation, and after pneumatic dilation in patients who did not respond to simple dilation. After simple dilation, two patients reported near resolution of symptoms. Supine RET revealed little improvement, but upright esophageal emptying was markedly improved at 2,5, and 10 minutes. In the two patients who had no relief after simple dilation, RET failed to show improvement while they were in either the supine or the upright position. These patients subsequently underwent pneumatic dilation that resulted In resolution of symptoms and marked Improvement in upright RET only. In the supine position, the esophageal emptying at 2 minutes in the four patients after successful dilation improved from 0% baseline to a mean of 14% (± 18%). However, in the upright position, esophageal emptying Improved from 3% (± 3%) to 73% (± 17%) and better correlated with symptomatic relief. The difference in improvement in esophageal emptying In the upright versus the supine position was statistically significant (P = 0.0033). The authors conclude that only upright esophageal emptying provides objective evidence that correlates well with symptomatic relief. Based on the authors' early experience, patients who had good symptomatic relief from treatment exhibited ≥ 50% (50–95%) esophageal emptying at 2 minutes when scanned upright after having a liquid meal.
A Measure of My Days: The Journal of a Country Doctor
Authors: Warren L. Holleman
Journal: Annals of Internal Medicine (1997)

Medical Writings15 October 1997A Measure of My Days: The Journal of a Country DoctorWarren L. Holleman, PhDWarren L. Holleman, PhDBaylor College of Medicine, Houston, TexasSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-127-8_Part_1-199710150-00040 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Loxterkamp D. Hanover, NH: Univ Pr of New England:1997.321 pages. ISBN 0874517990.$24.95. Order phone 800-421-1561.Field of medicine: Family medicine and primary care.Format: Hardcover book.Audience: Physicians, residents, and medical students interested in examining the life of a physician in a small town. The book is also directed toward readers interested in journaling as a means of spiritual insight and personal growth.Purpose: To give the reader access to the daily routine, the relationships, and the inner life of a vanishing species: the country physician. The reader follows the physician to the examination room, to meetings with colleagues ... Author, Article, and Disclosure InformationAffiliations: Baylor College of Medicine, Houston, Texas PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 October 1997Volume 127, Issue 8_Part_1Page: 660 ePublished: 15 August 2000 Issue Published: 15 October 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Bilateral Occipital Lobe Invasion in Chronic Lymphocytic Leukemia
Authors: Tsunayuki Kakimoto, Tomonori Nakazato, Ryuichiro Hayashi, Hiroyuki Hayashi, Norihide Hayashi, Taijiro Ishiyama, Hiroyuki Asada, Akaru Ishida
Journal: Journal of Clinical Oncology (2009)
Radiological prevalence of Paget's disease in Dunedin, New Zealand.
Authors: J C Reasbeck, A Goulding, D R Campbell, L R Beale, R D Stewart
Journal: BMJ (1983)

Radiological prevalence of Paget's disease in Dunedin, New Zealand Several recent surveys have shown regional variations in the prevalence of Paget's disease of bone.1 2 Although this condition is believed to be common in the elderly in New Zealand3 and many patients there receive treatment for it,4 its specific prevalence has not been measured in any New Zealand community.We therefore undertook a survey to determine the radiological prevalence of Paget's disease in subjects aged 55 or older living in Dunedin.