tbuckley/cabot-search huggingface dataset:
P141 Lung Volume reduction surgery--the first 200 operations in a UK centre: the benefits of a multidisciplinary strategy and minimally invasive approach
Authors: K. A. A. Aziz, I. F. Oey, D. A. Waller, M. D. Morgan, M. C. Steiner, S. J. Singh
Journal: Thorax (2010)

<h3>Objective</h3> Despite the supportive results of the randomised, controlled NETT trial, lung volume reduction surgery (LVRS) is still infrequently performed in the United Kingdom. We however, have persisted with video assisted thoracoscopic (VATS) LVRS and report the results of our first 200 operations. <h3>Patients/methods</h3> Surgical candidates for LVRS were selected by a multidisciplinary team approach using radionuclide scintigraphy in all cases. After the initial 20 open cases we adopted policy of two stage bilateral VATS LVRS with the timing of the second operation determined by the patient. 160 patients have completed one-stage LVRS: median age 60 (39–73) years and 20 patients have completed two-stage bilateral LVRS: median age 59 (41–66) years. Data from a prospective database were analysed to assess the postoperative changes in pulmonary function and health status (SF 36 questionnaire) recorded at three, six and, twelve months and thence annually. <h3>Results</h3> 30-day mortality was 6% and 25% required post-operative ventilation (9 of 50 for &lt;24 h). Hospital stay was 14 (2–110) days. FEV<sub>1</sub> in both groups showed significant continuous improved at the 3-month, 6-month and 1-year postoperative review (p≤0.035). Furthermore, significant improvements (p≤0.05) in SF 36 were seen across the seven domains assessed: Physical Functioning (up to 1 year), Social Functioning (up to 1 year), Role-Physical (up to 1 year), Role-Emotional (at 5 years), Mental Health (up to 1 year), Energy/Vitality (up to 1 year), and General Health (up to 1 year). There has however been a significant reduction in the domain of Bodily Pain up to 4 years post LVRS (p≤0.05). More lasting improvements are seen in two-stage bilateral group compared to the one-stage group. <h3>Conclusion</h3> The use of a multidisciplinary team approach and a prolonged surgical strategy can achieve durable postoperative benefits from LVRS for up to 4 years with acceptable risk.
CRASH trial is based on problematic meta-analysis
Authors: B Gregson, N V Todd, D Crawford, C J Gerber, B Fulton, L Tacconi, P J Crawford, R P Sengupta
Journal: BMJ (1999)

EDITOR—Kmietowicz reports the start of the CRASH trial, a multicentre trial of steroids for treating head injury.1 The meta-analysis which forms the basis for the trial is a good example of how one small study can potentially expose thousands of patients to unnecessary risk. The dose of steroids used in CRASH (2 g methyl prednisolone over 1 …
PreImplantation factor (PIF) potentiates static magnetic field (SMF) effect to decrease tumor burden (melanoma murine model)
Authors: Beatrix Kotlan, Janos F Laszlo, Jozsef Tovari, Miklos Kasler, Eytan Barnea
Journal: Journal for ImmunoTherapy of Cancer (2013)

Meeting abstracts PreImplantation factor (PIF) secreted by viable embryos exerts essential regulatory role on global systemic immune response. Synthetic PIF (PIF) translates endogenous effects to immune disorder models. Metastatic melanoma displays tumor-immunological behaviour. Static magnetic
P135 A novel composite index for prognostic staging of COPD patients
Authors: AK Boutou, A Nair, R Sandhu, DD Zadeh, DM Hansell, AU Wells, MI Polkey, NS Hopkinson
Journal: Thorax (2013)

<h3>Introduction</h3> Chronic Obstructive Pulmonary Disease (COPD) is characterised by high morbidity and mortality. Whether thorax computed tomography (CT)-derived parameters and lung function measurements carry more prognostic information individually or as a composite index has not yet been investigated. <h3>Aim</h3> a) to compare the prognostic value of CT-determined emphysema and PAAo ratio versus various lung function parameters in a general COPD population and b) to construct a composite index for prognostic staging of COPD patients. <h3>Material and Methods</h3> Predictors of mortality were assessed in a consecutive COPD outpatient population whose thorax CT, spirometry, lung volumes and gas transfer data were all collected prospectively in a clinical database. Univariate and multivariate Cox proportional Hazard analysis models were used and Hazard Ratios (HR) with corresponding 95% Confidence Intervals (CI) were calculated. Survival data were available until April, 2013 <h3>Results</h3> 169 patients were included (59.8% male, 61.1 years old). During the follow-up 20.1% died; mean survival was 115.4 months. Age (HR = 1.077; 95% Cl = 1.032–1.121) and emphysema score (ES) (HR = 1.033; 95% CI = 1.010–1.057) were the only independent predictors of mortality when ES was treated as continuous variable in the multivariate regression. No association was found between PAAo Ratio and survival. Further analysis indicated that the 55% threshold of ES could be used as optimal and the 30% and 65% thresholds as suboptimals for prognostic categorization of patients in “high” (ES≥65%), “low” (ES&lt;30%) and “intermediate” risk (30%≥ES&lt;65%) group. The TLC%predicted was the most discriminatory of all pulmonary function parameters, so its threshold of 143%, which corresponded to ES optimal threshold, was further applied for the construction of the index. The final composite index separated patients in “high” risk (ES≥65% or TLC&gt;143% predicted for intermediate group) and “low” risk (ES&lt;30% or TLC≤143% predicted for intermediate group) (Figure) and was more discriminatory (HR = 2.751; 95% CI = 1.272–5.951) than any of its individual components. <h3>Conclusion</h3> Although ES is better correlated with mortality than any pulmonary function parameter, a composite ES-TLC index carries the most prognostic information for COPD patients.
A phase 1 study of concomitant high-dose lenalidomide and 5-azacitidine induction in the treatment of AML
Authors: G Ramsingh, P Westervelt, A F Cashen, G L Uy, K Stockerl-Goldstein, C N Abboud, N Bernabe, R Monahan, J F DiPersio, R Vij
Journal: Leukemia (2012)
Research into scorpion stings
Authors: E. J. Mills, N. Ford
Journal: BMJ (2011)

Lack of funding and global investment are denying patients evidence based interventions

With the growth of global health schools and programmes at most universities in developed counties and the interest in neglected tropical diseases, it should follow that common medical conditions in developing settings are being researched.1 However, this is not so for scorpion stings, snake bites, and other animal envenomations. In the linked randomised clinical trial (doi:10.1136/bmj.c7136), Bawaskar and Bawaskar compare the effectiveness of scorpion antivenom plus or minus prazosin for the treatment of scorpion stings.2 The trial is a reminder that global health researchers often neglect conditions that matter to large impoverished communities⇓.



ephotocorp/Alamy

Of around 1500 species of scorpions worldwide, around 30 are potentially dangerous to humans.3 About 1.2 million scorpion stings occur worldwide each year, of which roughly 3250 are fatal. The incidence and severity vary geographically, with reported incidence among the general population …
TBX21 gene variants increase childhood asthma risk in combination with HLX1 variants
Authors: Kathrin Suttner, Philip Rosenstiel, Martin Depner, Michaela Schedel, Leonardo A. Pinto, Andreas Ruether, Jerzy Adamski, Norman Klopp, Thomas Illig, Christian Vogelberg, Stefan Schreiber, Erika von Mutius, Michael Kabesch
Journal: Journal of Allergy and Clinical Immunology (2009)
PM-02 * DIACYLGLYCEROL KINASE ALPHA INHIBITION PROLONGS SURVIVAL OF MICE WITH PRIMARY AND METASTATIC BRAIN TUMORS
Authors: D. Floyd, L. Comeau, S. Boroda, N. Hayes, D. Roller, A. Xiao, A. Friedman, L. Boyd, D. Gioeli, T. Harris, T. Harris, B. Purow
Journal: Neuro-Oncology (2014)

Diacylglycerol kinases (DGKs) are a family of highly conserved enzymes that are promiscuously responsive to growth factors and other mitogenic signaling cascades. DGKs are activated by binding of Ca2+ and phosphoserine, and catalyze conversion of diacylglycerol (DAG) to phosphatidic acid (PA). PA has multiple effects on downstream cellular signaling, while activated DGKs can associate with scaffolding proteins, or undergo degradation or translocation to the nucleus through atypical localization signals and thereby promote cell division and survival. A repurposed small-molecule inhibitor of DGKα activity is shown here to antagonize tumor growth in xenografts of primary and metastatic brain tumors and syngeneic mouse tumor grafts. Based on recent prior research and in this work in xenograft models, DGKα inhibition may arrest or kill tumors through cancer addiction to DGKα activity. Here, in syngeneic tumor models of primary and metastatic brain tumors, an additional anti-tumor effect of DGKα inhibition via up-regulation of normal immune function is possibly present. This work uses two syngeneic in vivo tumor models to compare DGKα inhibition with the monoclonal antibody immunotherapy anti-CTLA-4, and also tests the effect of combination of the two treatments on survival, tumor size, and immunologic activity. The anti-tumor activity of the DGKα inhibitor and the contribution of other DGK family members is shown using cell-based toxicity and flow cytometry assays. Direct interaction between the inhibitor and DGKα is shown with biochemical reconstitution of inhibitor-enzyme interactions These early results suggest that DGKα inhibition may be a promising strategy for patients with glioblastoma and melanoma brain metastasis.
Basal Interventricular Septal Thallium-201 Defects: Real or Artifact?
Authors: NIEL F. STARKSEN, WILLIAM O??CONNELL, MICHAEL W. DAE, ELIAS H. BOTVINICK
Journal: Clinical Nuclear Medicine (1993)

Misinterpretation of reversible defects at the base of the interventricular septum is perhaps among the greatest single causes of false positive TI-201 myocardial perfusion images. This is a report of a patient with angiographically documented ischemia at the base of the septum and corresponding reversible defects as seen using TI-201 imaging. Illustrated are two different forms of malalignment artifact that duplicate this patient's findings in a patient with normal perfusion.
Blinding Trachoma in Postconflict Southern Sudan
Authors: Jeremiah Ngondi, Francis Ole-Sempele, Alice Onsarigo, Ibrahim Matende, Samson Baba, Mark Reacher, Fiona Matthews, Carol Brayne, Paul Emerson
Journal: PLoS Medicine (2006)

Trachoma is a leading cause of preventable blindness. Reports from eye surgery camps and anecdotal data indicated that blinding trachoma is a serious cause of visual impairment in Mankien payam (district) of southern Sudan. We conducted this study to estimate the prevalence of trachoma, estimate targets for interventions, and establish a baseline for monitoring and evaluation.A population-based cross-sectional survey was conducted in May 2005. A two-stage cluster random sampling with probability proportional to size was used to select the sample population. Participants were examined for trachoma by experienced graders using the World Health Organization simplified grading scheme. A total of 3,567 persons were examined (89.7% of those enumerated) of whom 2,017 were children aged less than 15 y and 1,550 were aged 15 y and above. Prevalence of signs of active trachoma in children aged 1-9 y was: trachomatous inflammation-follicular (TF) = 57.5% (95% confidence interval [CI], 54.5%-60.4%); trachomatous inflammation-intense (TI) = 39.8% (95% CI, 36.3%-43.5%); and TF and/or TI (active trachoma) = 63.3% (95% CI, 60.1%-66.4%). Prevalence of trachomatous trichiasis was 9.6% (95% CI, 8.4%-10.9%) in all ages, 2.3% (95% CI, 1.6%-3.2%) in children aged under 15 y, and 19.2% (95% CI, 17.0%-21.7%) in adults. Men were equally affected by trichiasis as women: odds ratio = 1.09 (95% CI, 0.81%-1.47%). It is estimated that there are up to 5,344 persons requiring trichiasis surgery in Mankien payam.Trachoma is a serious public health problem in Mankien, and the high prevalence of trichiasis in children underscores the severity of blinding trachoma. There is an urgent need to implement the surgery, antibiotics, facial cleanliness, and environmental change (SAFE) strategy for trachoma control in Mankien payam, and the end of the 21-y civil war affords an opportunity to do this.
Children in an ageing society
Authors: D M B Hall
Journal: BMJ (1999)

This paper explores the implications of demographic aging for children and pediatric practice in the Western society. It focuses on the social class differences in childbearing patterns, specific issues related to disability, and distribution of resources between age groups. Women in the Western world are now having children at an older age than at any time in the past 50 years. Voluntary childlessness or deliberate delay in childbearing is common among highly educated women. This changing pattern in childbearing may increase and polarize health and wealth inequalities. With advancements in neonatal and pediatric care which prolong life expectancy and survival of disabled children, it is projected that there will be an increasing number of very old parents caring for severely disabled offspring. Meanwhile, there are also many children who are carrying considerable burdens of caring for their disabled parents. The community burden of disability will continue to rise. The needs of the elderly population may drain resources from child health services. Despite this demographic pattern, care for the children is still important. Health care authorities must not become contented with the existing pediatric care services just because demographic changes require that the nation should invest more in care of the older population.
Depletion of Bone Marrow CCSP-Expressing Cells Delays Airway Regeneration
Authors: Martha L Bustos, Marco Mura, David Hwang, Olga Ludkovski, Amy P Wong, Armand Keating, Thomas K Waddell
Journal: Molecular Therapy (2014)

The contribution of bone marrow cells (BMC) in lung repair is controversial. We previously reported a subpopulation of BMC that express Clara cell secretory protein (CCSP). To determine the contribution of endogenous CCSP(+) BMC to airway regeneration, we performed bone marrow transplantation studies using the CCtk mouse, which expresses a thymidine kinase suicide gene under regulation of the CCSP promoter. Mice were transplanted with wild-type or CCtk BMC and treated with ganciclovir to eliminate CCSP(+) cells. After airway injury using naphthalene, mice depleted of CCSP(+) BMC had more inflammatory cells in lung and decreased levels of oxygen in arterial blood. They also had reduced expression of airway epithelial genes and less Clara cells compared to control mice that had intact CCSP(+) BMC and bone marrow derived CCSP(+) cells in the airways. After naphthalene injury, administration of CCSP reproduced the beneficial effect of CCSP(+) BMC by improving recovery of airway epithelium, reducing lung inflammation and increasing oxygen in arterial blood from mice depleted of CCSP(+) BMC. Our data demonstrate that ablation of CCSP(+) BMC delays airway recovery and suggests the beneficial effect of CCSP(+) BMC in lung recovery is in part due to production of CCSP itself.
Systemic infections mimicking thrombotic thrombocytopenic purpura
Authors: Kristina K. Booth, Deirdra R. Terrell, Sara K. Vesely, James N. George
Journal: American Journal of Hematology (2011)

The absence of specific diagnostic criteria, the urgency to begin plasma exchange treatment, and the risk for complications from plasma exchange make the initial evaluation of patients with suspected thrombotic thrombocytopenic purpura (TTP) difficult. Systemic infections may mimic the presenting clinical features of TTP. In the Oklahoma TTP-HUS (hemolytic-uremic syndrome) Registry, 1989-2010, 415 consecutive patients have been clinically diagnosed with their first episode of TTP; in 31 (7%) the presenting clinical features were subsequently attributed to a systemic infection. All 31 patients had diagnostic criteria for TTP; 16 (52%) had the complete "pentad" of microangiopathic hemolytic anemia, thrombocytopenia, neurologic abnormalities, renal failure, and fever. Four (16%) of 25 patients who had ADAMTS13 measurements had <10% activity; three patients had a demonstrable ADAMTS13 inhibitor. Compared with 62 patients with severe ADAMTS13 deficiency (<10%) who had no recognized alternative disorders, patients with systemic infections had more frequent fever, coma, renal failure, and the complete "pentad" of clinical features. Seventeen different infectious etiologies were documented. A systematic literature review identified 67 additional patients with a diagnosis of TTP or HUS and also a systemic infection. Among all 98 patients, infections with 41 different bacteria, viruses, and fungi were documented, suggesting that many different systemic infections may mimic the presenting clinical features of TTP. Initial plasma exchange treatment is appropriate in critically ill patients with diagnostic features of TTP, even if a systemic infection is suspected. Continuing evaluation to document a systemic infection is essential to determine the appropriateness of continued plasma exchange.
PVC: health implications and production trends.
Authors: M Karstadt
Journal: Environmental Health Perspectives (1976)

Poly(vinyl chloride) (PVC) is a complex plastic system. Individual components of the PVC system, including residual vinyl chloride monomer (RVCM) and certain additives, may pose risks of harm to human health. There have been significant reductions in the RVCM content of PVC resin since 1974, reducing the cancer risk of workers in PVC fabrication plants and consumers of PVC products. A
Role of tissue transglutaminase 2 in the acquisition of a mesenchymal-like phenotype in highly invasive A431 tumor cells
Authors: Chun-Yu Lin, Pei-Hsun Tsai, Chithan C Kandaswami, Geen-Dong Chang, Chia-Hsiung Cheng, Chang-Jen Huang, Ping-Ping Lee, Jiuan-Jiuan Hwang, Ming-Ting Lee
Journal: Molecular Cancer (2011)

Abstract Background Cancer progression is closely linked to the epithelial-mesenchymal transition (EMT) process. Studies have shown that there is increased expression of tissue tranglutaminase (TG2) in advanced invasive cancer cells. TG2 catalyzes the covalent cross-linking of proteins, exhibits G protein activity, and has been implicated in the modulation of cell adhesion, migration, invasion and cancer metastasis. This study explores the molecular mechanisms associated with TG2's involvement in the acquisition of the mesenchymal phenotype using the highly invasive A431-III subline and its parental A431-P cells. Results The A431-III tumor subline displays increased expression of TG2. This is accompanied by enhanced expression of the mesenchymal phenotype, and this expression is reversed by knockdown of endogenous TG2. Consistent with this, overexpression of TG2 in A431-P cells advanced the EMT process. Furthermore, TG2 induced the PI3K/Akt activation and GSK3β inactivation in A431 tumor cells and this increased Snail and MMP-9 expression resulting in higher cell motility. TG2 also upregulated NF-κB activity, which also enhanced Snail and MMP-9 expression resulting in greater cell motility; interestingly, this was associated with the formation of a TG2/NF-κB complex. TG2 facilitated acquisition of a mesenchymal phenotype, which was reversed by inhibitors of PI3K, GSK3 and NF-κB. Conclusions This study reveals that TG2 acts, at least in part, through activation of the PI3K/Akt and NF-κB signaling systems, which then induce the key mediators Snail and MMP-9 that facilitate the attainment of a mesenchymal phenotype. These findings support the possibility that TG2 is a promising target for cancer therapy.
NOTES ON THE TREATMENT OF ERYTHEMA NODOSUM, URTICARIA, AND ERYSIPELAS
Authors: W. S. Oke
Journal: BMJ (1853)

lwrge supply of blood to the uterus during pregnancy; and this view is, I think, confirmed by Dr. Qusin's microscopic examination, and by the appearance of another preparation, which I alsoIexhibited, and also by the way in which it was covered, and, as it were, entangld by the convolutions of the intestines.So&urce of the hlrmorrhage.Upon this point there can, I think, be but little doubt; for upon elevating the uterus, with the tumour attached, a laceration, about two inches in extent, in the peritoneum, going from the posterior part of the uterus to the tumour, was at once apparent; and as there was no other laceration in that membrane, it seems all but certain that the bleeding had proceeded from it.This constitutes the great peculiarity in the case, as it is the only one with which I am acquain;ed where a fibrous tumour of the uterus has terminated fatally in that way.Cause and Time of the Ikemorrhaqe.At the cause and time of the bleeding, there is some difficulty in arriviing.
The pharmacologic and clinical properties of Oxis® (formoterol) Turbuhaler®
Authors: O. Selroos
Journal: Allergy (1998)

Oxis Turbuhaler has been approved for use in Europe at doses of 6, 12, or 24 micrograms once or twice daily. It has a rapid onset of action (within minutes) and demonstrates a maintained effect on airway function (an improvement of 20-30 l/min in PEF is seen 12 h after dosing), and it is well tolerated and safe. It decreases the incidence of acute asthma attacks, stimulates an immediate increase in PEF (in the order of 40-45 l/min), is effective when given in conjunction with anti-inflammatory medication, and has been shown to maintain a level of asthma control in all studies performed. Hence, Oxis Turbuhaler is a clinically relevant tool for use in patients receiving inhaled corticosteroids who require additional control of their asthma symptoms.
Physicians and Pharmaceutical Sales Representatives
Authors: Robert F. Perry
Journal: JAMA (1995)

<h3>To the Editor.</h3> —The report by Dr Ziegler and colleagues,<sup>1</sup>who found that 11% of statements made by pharmaceutical representatives to physicians are contradictory to readily verifiable information, hardly seems a revelation. Similarly, it is not surprising that those false utterances invariably cast the promoted product in a favorable light. What may be challenged, however, are the authors' contentions that physicians generally fail to recognize those inaccuracies and, further, that approximately four of 10 doctors substantially rely on the information provided by pharmaceutical sales representatives in deciding to prescribe a particular drug. The study by Ziegler et al contains a number of flaws. The sample population was small (n=27), and the study assessed only the practices of house officers. Because the "target customer" for drug companies is the community-based practitioner, conclusions related to physician behaviors based exclusively on the responses of resident physicians lack validity. Additionally, because the information
Training our doctors
Authors: Fiona Godlee
Journal: BMJ (2007)

We have pondered the BMJ 's coverage of the UK's crisis in specialist training. Our critics might characterise it as too much too late: too much for readers outside the UK, too late to have influenced decisions being made behind closed doors and to mitigate some of the heartache, upset, and upheaval.

Amid the long list of factors that contributed to the tsunami of MMC and MTAS (well described by Madden and Madden recently: BMJ   2007;335:426-8 doi: 10.1136/bmj.39300.591632.DE) one factor has been studiously avoided in most discussions—medical immigration. Difficult though it is to raise, it cannot be ignored.

We decided a few months ago to commission …
B cells in early and chronic HIV infection: evidence for preservation of immune function associated with early initiation of antiretroviral therapy
Authors: Susan Moir, Clarisa M. Buckner, Jason Ho, Wei Wang, Jenny Chen, Amy J. Waldner, Jacqueline G. Posada, Lela Kardava, Marie A. O'Shea, Shyam Kottilil, Tae-Wook Chun, Michael A. Proschan, Anthony S. Fauci
Journal: Blood (2010)